
Book :._•_ 



Copyright . 



COPYRIGHT DEPOSrr. 



TREATISE 



ON 



Acology and Therapeutics. 



WITH 



SOME OF THE MOST PROMINENT 
PRINCIPLES AND RULES 



OF 



CHEMICAL AND MECHANICAL PHARMACY. 



BY 

J. G. WESTMORELAND, M.D., 

Professor of Materia Medica and Therapeutics in Atlanta Medical College. 



ATLANTA, GEORGIA. 

Plantation Publishing Company's Peess. 
1873. 




^ 



\H 



5^ 



Entered, according to Act of Congress, in the year 1873, by 

JOHN G. WESTMORELAND, M.D., 

In the Office of the Librarian of Congress, at Washington. 



•ro 
WILLIS F. WESTMORELAND, M.D., 

rBOPESSOR OF SURGERY IN ATLANTA MEDICAL COLLEGE, 
AS A TESTIMONY OF ESTEEM 

FOR AN ONLY BROTHER, 

WHOSE LIFH HAS BEEN DEVOTED TO THE 

SCIENCE AND ART OF SURGERY; 

TO THE 

TRUE PRINCIPLES OF THE MEDICAL PROFESSION,. 

AND TO THE 

CAUSE OF HUMANITY, 

Cjfis Volvm 

IS AFFECTIONATELY INSCRIBED, BY 

THE AUTHOR, 



PREFACE 



As a text-book for the student of medicine the work now pre- 
sented to the public was in contemplation, and partially arranged, 
several years since ; but various circumstances prevented its ear- 
lier publication. 

The author has been for a long while impressed with the im- 
portance of a system of classification which would present to the 
learner, remedies grouped together, and classes named in accord- 
ance with their natural, direct physiological action. In the 
accomplishment of this object, it is believed that incalculable 
advantage is afforded in the study of remedies and their thera- 
peutic use. 

The increased facilities for learning and appreciating the direct 
action of medicine, will doubly compensate for the inconvenience 
and confusion arising from new names of classes, and the change 
of certain agents from their usual arrangement in works on 
Materia Medica. . 

The changes adopted in chemical nomenclature have been made 
more to harmonize with the United States Pharmacopoeia than 
for any practical advantage likely to be obtained by them. The 
late decennial revision authorized by the Convention of 1870, 
requires that the salts of alkaline bases be named with reference 
to the elementary substance, and not as heretofore in accordance 
with the oxide of the metal or metaloid. Thus, "nitrate of po- 
tassa" a name expressing the union of an acid with an oxide of 
potassium, has been changed to "nitrate of potassium," etc. These, 
with other innovations of the code, such as the adoption of new 
preparations and the rejection of some hitherto recognized, have 
been adopted in this work. 



N ; I'Kr.iAti.. 

It will be found thai in some of the classes, only a few articles 
:llv men tioned. This is owing to the fact that many remedies 
used in the treatmenl of disease have been given rather empiric- 
ally, with the expectation of certain therapeutic results without, 
however, any knowledge of, or regard for, the immediate action 
bad by them. There arc many of these about which nothing is 
certainly known, so far as their direct action is concerned, and 
which, therefore, cannot be arranged in a classification founded 
on physiological action. ^ 

In the adoption of names* for the classes, which indicate the 
action had, and the part affected by the remedies included, those 
in general use, denoting the functional changes likely to follow 
their use, have been also retained in some instances. For exam- 
ple, the names, " emetics" and "cathartics," are retained along 
with " inverse gastric excitants" and "enteric excitants." This 
course serves the purpose of directing the minds of those who 
have already studied them, to the groups of remedies which have 
the physiological actions indicated, and also of impressing the 
beginner with the results to be expected. 

While perfection is not claimed for the classification and 
arrangement adopted, it is believed that great advantages will 
be afforded the learner in directing his mind to the funda- 
mental principles of rational medicine. If in this he is success- 
ful, the author feels satisfied that his labors have not been in vain. 



TABLE OF CONTENTS. 



PHAKMACOLOGY. 

Introduction. — Materia Medica, Acology, Therapeutics, Remedies, . . 1 

Psychical Influences. — Love, Anger, Hatred, Joy, Hope, Fear, Disgust 

and Sorrow, . . . . . . . . . .2 

Somatical Remedies. — Pharmacological Substances, Physical Remedies, 

Drugs, Medicines, . ......... 7 

Hygiene. — Light, Air, Water, Exercise, Sleep, Diet and Drinks, . . 8 

Pharmacy. — Collecting Drugs: Roots, Perennials, Leaves, Flowers, Barks, 
Seeds. Collecting and Packing: Roots, Leaves, Flowers, Barks and 
Seeds of Annuals, Biennials and Perennials, . . . . . 13 

Weights and Measures. — Troy or Apothecaries' Weight, and Wine or 
Apothecaries' Measure (U. S.) ; Weights and Measures (Br.) ; Relative 
Value of U. S. and French Weights ; Relation of British Weights to 
Measures ; Relation of British to Metrical Weights ; Relation of Brit- 
ish to Metrical Measures ; Relation of French to U. S. Measures ; 
Relation of French to U. S. Long Measure, . . . . .17 

Pharmaceutic Chemistry. — Material Agents, Bodies, Simple and Com- 
pound, Elementary Bodies, Matter, Synthesis, Analysis, Chemical 
Equivalents, Nomenclature, Acids, ...:... 21 

Mechanical Operations of Pharmacy. — Pulverization, Contusion, Ma- 
ceration, Digestion, Solution, Elutriation, Expression, Filtration, De- 
cantation, Despumation, Percolation or Lixiviation, Vaporization, 
Evaporation, Inspissation or Exciccation, Crystalization and Distilla- 
tion, 25 

Forms of Preparation. — Solids: Pills, Powders, Lozenges or Troches, 
Suppositories and Plasters. Liquids: Tinctures, Decoctions, Infu- 
sions, Wines, Vinegars and Solutions. Semi-Fluids: Syrups, Cerates, 
Ointments, Liniments and Lotions, 29 

Parts to which Remedies are Applied. — Stomach, Rectum, Skin, Nose, 

Lungs, 36 



Vlll TABLE OF CONTENTS. 

BiODUl OrK.uANDi of Remedies. — Local Remedies, Elective Remedies; Ac- 
tion through Mechanical Process, Action through Chemical Process, 
and Action through Vital Process ; Primary Action, Secondary Ac- 
tion ; Direct Therapeutic Results, Indirect Therapeutic Results, . 43 

Circumstances which Modify the Action of Remedies. — Climate, Age, 

Sex, Idiosyncrasy, Habit, Temperament, . . . . .49 

Classification of Remedies. — Table of Physiological Classification, Or- 
ders, Sub-orders, Divisions and Classes, 55 

ACOLOGY AND THERAPEUTICS. 

ORDER I. — Local Remedies. 

SUB-ORDEK I— Local Action through Vital Process. 

DIVISION I.— Remedies that Affect the Skin. 

CLASS I. — Rubefacients. Sinapis, Oleum Terebinthinae, Capsicum, Chlo- 
ral, Olea Aromaticus, Aqua Ammonise, Chloroformum, iEther, . . 63 
CLASS II. — Vesicants. Cantharis, Aqua Ammonise, Caloric, ... 68 
CLASS III. — Pustulants. JJnguentum Antimonii, Oleum Tiglii, . . 73 

DIVISION 11.— Remedies that Affect all Soft Tissues. 

CLASS I. — Astringents. Plumbi Acetas, Geranium, Quercus, Galla, Ac- 
idum Tannicum, Acidum Gallicum, Rubus, Kino, Krameria, Catechu, 
Hgematoxylon, 75 

CLASS II. — Catheretics. Iodinum, Acidum Carbolicum, Zinci Sulphas, 
Cadmii Sulphas, Argenti Nitras, Zinci Chloridum, Cupri Sulphas, 
Iodoformum, .85 

CLASS III. — Aromatic Local Excitants. Cinnamon, Zingiber, Cary- 
ophyllus, Mentha Piperita, Mentha Viridis, Calamus, Cascarilla, Lav- 
andula, Anisum, Foeniculum, Pimenta, Piper, Myristica, Aurantii 
Cortex, Vanilla, Canella, Coriandrum, Cardamomum, . . .97 

SUB-OKDER II.— Local Action through Ohemioal Process. 

DIVISION I. — Remedies that Affect Adventitious Substances and Structures. 

CLASS I. — Anthelmintics. Spigelia, Chenopodium, Azedarach, Granati 
Radicis Cortex, Pepo, Brayera, Rottlera, Hydrargyrum, Filix Mas, 

Santonica, 109 

CLASS II. — Escharotics. Potassa, Cauterium Actuale, Acida Minerales, 121 
CLASS III. — Antiseptics. Creasotum, Acidum Carbolicum, Calx, Chlo- 
rine, Carbo Ligni, . 123 



TABLE OF CONTENTS. IX 

SUB-OEDEE III.— Local Action through Mechanical Process. 
DIVISION I. — Remedies that Affect Internal and External Surfaces. 

CLASS I. — Demulcents. Acacia, Linum, Ulmus, Chondrus, Cetraria, 
Sesamum, Sassafras Medulla, Amylum, Glycerina, Althaea, Symphy- 
tum, Oleum Olivas, Bismuthi Subnitras, 129 

CLASS II. — Emolients. Pulvis Ulmi, Lini Farina, Symphytum, . 138 

CLASS III. — Mechanical Counter-Irritants and Depletives. Hirudo, 

Cucurbitula, Acupunctura, Setaceum, Fonticulus. Moxiburium, . 141 

jR ^IR,T III, 
ORDER II. — Elective Remedies. 

SUB-OEDEE I. —Elective Action through Chemical Process. 

DIVISION I.— Remedies that Affect the Blood. 

CLASS I. — FLematinics. Cibus, Ferrum, Oleum Morrhuse, Transfusio, 148 
CLASS II. — Span-Emics. Blood-letting, Mercury, Low Diet, . . . 15G 
CLASS III.— Diluents. Infusions, ....... 157 

CLASS IV. — Haemostatics. Plumbi Acetas, Ferri Chloridum, Argenti 

Nitras, Acidum Carbolicum, Ferri Persulphas, .... 158 

CLASS V. — Catalytics. Hydrargyrum, Iodinum, Sarsaparilla, Stil- 
lingia, Arsenicum, Acidum Sulphurosum, Chloroformum, Ammonii 
Chloridum, Chimaphila, Antacida, ....... 168 

SUB-OEDEE II.-Elective Action through Vital Process. 

DIVISION I. — Remedies that Affect the Alimentary Canal. 

CLASS 1. — Inverse Gastric Excitants or Emetics. Ipecacuanha, Gille- 
nia, Sanguinaria, Tabacum, Zinci Sulphas, Cupri Sulphas, Cadmii Sul- 
phas, Hydrargyri Sulphas Flava, . . . . . . . 185 

CLASS II. — Enteric Excitants. Aperients, Purgatives, Drastics. 

Mild Enteric Excitants or Aperients : Olem Olivae, Manna, Magnesia, 
Pulveres Effervescent.es. 

Thorough Enteric Excitants or Purgatives: Hydrargyrum, Rheum, Aloe, 
Juglans, Oleum Ricini, Magnesii Sulphas, Sodii Sulphas, Senna, Cas- 
sia Marilandica. 

Violent Enteric Excitants or Drastics: Jalapa, Podophyllum, Scam- 
monium, Garnbogia, Colocynthis, Elaterium, Oleum Tiglii, Leptandra, 200 

CLASS III. — Gastric or Digestive Tonics. Cibus, Pepsin, Calumba, 
Frasera, Gentiana, Gentiana Catesbaei, Quassia, Coptis, Sabbatia, Acida 
Mineral es, . - ' 229 



X TABLE OF CONTENTS. 

DIVISION l\.— Remedies that affect the Heart. 

CLASS I. — Cardiac Stimulants. Capsicum, Oleum Terebinthinae, Am- 

monii Carbonas, . . . . . . . . . .251 

CLASS II. — Cardiac Sedatives. Veratrum Viride, Depletio, Frigidus, 

Antimonii et Potassii Tartras, Potassii Nitras, ..... 250 

CLASS III. — Cardiac Tonics. Digitalis, Prunus Virginiana, Acidum Hy- 

drocyanicum, . 209 

DIVISION III. — Remedies that affect the Mucous Memhronw. 

CLASS I. — Blennymenal Stimulants. Oleum Terebinthinae, Copaiba, Bal- 
samum Tolutanum, Balsamum Peruvianum, Senega, Eucalyptus, Col- 
linsonia, Ammonia, Phellandrum Aquaticum, Styrax, . . . 270 

DIVISION IV. — Remedies that affect the Nervous System. 

CLASS I. — Cerebral Stimulants. Opium, Chloroforum, Alcohol, Hyos- 

cyamus, Stramonium, Belladonna, VEther, Cannabis Indica, . . 2K7 

CLASS II. — Cerebral Sedatives. Anaesthetic Cerebral Sedatives, Pros- 
trating Cerebral Sedatives. 

Anesthetics: iEther, Chloroformum, Nitrous Oxide, Chloral. 
Prostrating Cerebral Sedatives: Tabacum, Acidum Hydrocyancum, . .107 

CLASS III.— Cerebral Tonics. Phosphorus, Zinci Sulphas, Cuprum, 

Argenti Nitras, Centaurea, Bromihum, 314 

CLASS IV. — Excito-motor Stimulants. Nux Vomica, Arnica, Electri- 
city, 322 

CLASS V. — Excito-motor Sedatives. Conium, Woorari, Physostigma, 320 

CLASS VI. —Spinal Nervous Stimulants. Assafoetida, Moschus, Cerium, 

Oleum Succini, Castoreum, Caffea, ....... 329 

CLASS VII. — Spinal Sedatives. Gelsemium, 330 

CLASS VIII. — Spinal Tonics. Cinchona, Salix, Cornus, Impluvium, Cim- 

icifuga, 338 

DIVISION V. — Remedies that Affect the Secernent System. 

CLASS I. — Hepatico-Salivary Stimulants. Hydrargyrum, . .347 

CLASS II. — Hepatic Tonics. Acida Minerales, Taraxacum, . . 361 
CLASS III. — Renal Stimulants. Oleum Terebinthinae, Cantharis, Co- 
paiba, Juniperus, Sabina, . . . ..... 354 

CLASS IV. — Renal Sedatives. Potassii Nitras, Potassii Bitartras, Spir- 

itus /Etheris Nitrosi, . - 358 

CLASS V.— Renal Tonics. Scilla, Uva Ursi, Tinctura Ferri Chloridi, 

Digitalis, Buchu, 361 

DIVISION IV. — Remedies that Affect the Procreative Organs. 

CLASS I. — Genital Stimulants. Cantharis, Cannabis Indica, . . 307 

CLASS II. — Genital Sedatives. Gelsemium, Lupulina, Camphora, . 309 

CLASS III. — Uterine Stimulants. Ergota, Gossypii Radix, . . .171 

CLASS IV. — Uterine Sedatives. Viburnum, Opium, . . . . 375 



I 



iCOLOGY AND THERAPEUTICS 



IF> _A_ IR, T I. 



PHARMACOLOGY 



INTRODUCTION. 



The advantages to the learner, derived from elementary works 
on Acology, consist chiefly in the classification of remedies upon 
their known physiological action, and their modus operandi in 
the cure of disease. A treatise on this subject, therefore, should 
be devoted more to the selection and arrangement of agents 
having a particular action, than the association, in one item, of 
all the properties possessed by a single article. The latter plan 
is carried out in the alphabetical order of Dispensatories, 
which serve as reference for the full history of all known reme- 
dies. 

In a practical work on Therapeutics, the student of medicine 
expects to find grouped together the prominent articles of classes, 
forming the necessary resources upon which to draw for any given 
action. Works of this kind are found under the titles of "Ma- 
teria Medica," "Acology," "Therapeutics," etc., and with very 
different forms of classification. 

Materia Medica is the term usually applied to the branch 
of medical science which teaches the description and properties of 
medicinal agents. Strictly speaking, the name denotes material 
1 



'1 tCOLOGl 

agents alone, but, by the liberal definition allowed, i> made to in- 
clude remedies of every kind — their history, description, proper- 
ties, preparations and modus operandi. 

A.COLOGY- -Acofoffiti, from '//'C, a remedy, and /<>yi>:, a treatise 
or discourse, was suggested by Pereira, as a more appropriate 
name, and literally means what is understood by Materia Medica. 

The consideration of remedies will, of course, necessarily 
include all of every variety of means, used in the palliation and 
cure of disease, material and immaterial. Even mechanical 
agencies, described in works on Surgery and Obstetrics, may 
also, with propriety, be included. 

Therapeutics — from depaneua*, to cure — treats of remedies 
and their application in the treatment of disease. The extensive 
scope allowed by this term would naturally include the subjects 
connected with Acology and the Practice of Medicine. To cure 
disease requires a knowledge of remedies, and the nature of 
affections for which they are used. 

Remedies, consist of material and immaterial agents. The 
latter operate chiefly upon the mind, and are, hence, called 
psychical; the former upon !-he body, and are, therefore, termed 
somatical. 

Material agenffe are made up of ponderable and imponderable 
substances. The former are subject to preparation by phar-na- 
ceutic operations, and are termed pharmacological agents. 
Light, heat and electricity, belonging to the latter, are not only 
remedial agents within themselves, but are also used in the ope- 
rations of pharmacy. 

PSYCHICAL INFLUENCES. 

Psychical — from turr/r /} mind — is applied to operations or 
influences intended for their direct effects in mental disorders, 
or to affect physical structures, indirectly through the mind. 

The mental control exerted over certain functions of the body is 
notorious. Passions or emotions being excited in a high degree, 
are known to arrest, in some instances, and in others, to increase 
inordinately the action of organs, and modify the effects of reme- 
dies. 



PSYCHICAL REMEDIES. 3 

The passions which thus disturb certain functions in health, 
and modify pathological conditions are, love, anger and hatred. 

The emotions are, joy, hope, jear, disgust and sorrow. 

Attachment for objects and persons tends, in various ways, to 
affect the organism of mankind. Confidence, the legitimate 
offspring of attachment, is an important means of insuring 
the full benefit of ordinary medication. Without it, medicines 
are administered with the greatest difficulty. In such case, 
promptness, in the time of administration and the quantity to be 
taken, is not likely to be observed; and, in consequence, the 
desired impression fails to be realized. And should these diffi- 
culties be overcome, that quiet, undisturbed condition of mind, 
so neeessrry to the restoration of diseased organs, is not obtained, 
while there is a dislike for. and want of confidence in, the attending 
physician. 

On the other hand, inordinate affection so changes certain 
sensations or functions, that manifest embarrassment is met with 
from this cause. The usual desire for food, under such circum- 
stances, is generally wanting, and the amount necessary to afford 
proper support will not invariably be taken. The soothing 
influence of this passion upon the nervous system, however, and 
through- it upon the whole body, is sometimes very marked. The 
etfept upon the mind, when not excessive, is that of a pleasurable 
sensation, and under its benign influence irritability of the ner- 
vous system is, to some extent, allayed. Tranquilizing influences 
of this kind not only modify appreciation by the brain of local 
nervous disturbance, but also tend to quiet it, by the direct con- 
trol over the great center. 

Anger, as a remedial agent, is rarely brought into requisition; 
but, on the contrary, is a fruitful source of mischief ordinarily. 
In some mental affections, however, and in nervous diseases, from 
which the imagination is morbidly active, the despondency, ennui 
and foreboding of coming evil, are sometimes greatly relieved by 
such irritating cause as temporarily stirs up the patient's ire. It 
acts as a kind of mental revulsive or counter irritant. The 
mind, which before was occupied by depressing thoughts, is 
aroused by the excitement, and for a time does not indulge 



4 ACOLOGY. 

unwarranted conjectures. In hypochondriasis, and chronic 
organic disease, the mind often relapses iuto a state peculiarly 
suited to the remedial effects of such mental agitation, when prop- 
erly controlled. 

Hatred, a passion almost invariably indulged injuriously to 
the subject, is mentioned in this connection more with the view 
of guarding against its baneful influence. The object of this 
passion, when present, is likely to arouse the subject to anger. 
Jn this way the mental impressions before alluded to, as occa- 
sionally beneficial, in despondency, may be brought to bear, but 
it must be borne in mind that these instances are very rare, and 
that injurious effects more frequently follow. 

Joy, though detrimental in a high degree when excessive, is 
sometimes made the remedy for depressed conditions of the men- 
tal faculties, and through them an excitant of the general nervous 
energies. 

Hope, of all the mental influences, is, perhaps, most useful in 
the management of ordinary disease. Instances are constantly 
occurring, in which the vital energies are so depressed from des- 
pondency that the means of treatment instituted fail to accom- 
plish the desired end, until hope is inspired. In the absence of 
this necessary incentive, remedies prescribed are improperly 
taken and imperfectly retained, from the utter carelessness as to 
the means employed. Despair of recovery under any treatment 
leads to like difficulties in obtaining the full effects of remedial 
agents. The idea above advanced, touching the importance of 
confidence in the attending physician, is particularly applicable 
here. So important is it, that his usefulness is destroyed when it 
does not exist. To insure confidence and hope should be one 
main object of practitioners, on assuming the responsible duties 
of prescribing physician. On the other hand, false expectations 
should not usually be encouraged. "Hope deferred maketh the 
soul sick/' is the Patriarchal axiom, true in matters of Divine 
government, and no less so in "the healing art." Promises 
beyond what can possibly be realized shotdd not generally be 
made. In fact, though full disclosures of unfavorable prognosis 
are not called for, yet all positive statements to the patient should 
be made strictly in accordance with truth. 



rs\( IHICAL REMEDIES. 5 

FearJ with many invalids, is the only moans by which to 
insure strict compliance with directions for the administration of 
remedies ; and the apprehension of danger, with them, is the 
only incentive to seek medical aid. The excessive exercise ol this 
emotion, however — beyond that necessary to awaken the proper 
degree of interest — is depressing and injurious from the violent 
mental agitation excited. 

Sorrow. — This emotion always interferes, more or less, with 
the comfort and wellbeing of the subject, and with the desired 
action of remedial agents. Facts calculated to produce it should, 
when practicable, be concealed from the subject of dangerous 
illness. A certain amount of buoyancy being necessary to sus- 
tain physical strength under violent afflictions, such depressing 
influences should always be avoided, if possible. It is not only 
necessary that facts calculated to produce prostrating grief should 
be kept from the sick, but the suspicion of sad news having been 
received, should be prevented by avoiding low, earnest conversa- 
tion between friends in sight or hearing of very feeble invalids. 

The various avenues through which the mind receives impres- 
sions, leading to the passions and emotions above alluded to, 
require some consideration. 

Through the five senses, connection with, and appreciation by, 
the mind, of external objects and circumstances, are effected. 
The organ of mind is intimately connected with the several 
organs of sense, and has endow r ed them liberally with special 
nerves. To this connection, and the exercise of mental faculties, 
perception is due. The mind is made cognizant of passing 
events, principally through hearing and sight. Feeling or touch, 
taste and smell, communicate to the sensorium the quality of 
bodies, and are, therefore, little concerned in the production of 
psychical influences, operating in the exercise of the mental fac- 
ulties to the modification of disease. 

Through the media of audition and sight, facts are made 
known. Not alone by oral or written language received through 
these avenues, but also by movement, gesture, etc., are surround- 
ing circumstances manifested. 

The morbid state of certain organs is sometimes aggravated 
through these senses. In cephalalgia, an ordinary degree of light 



6 ACOLOGt. 

and sound increases (lie buffering, and when inflammation of the 
brain, or its meninges exists, tend- to aggravate it. 

Moreover, the therapeutic application of. remedies i> sometimes 
materially interferred with in the exercise of these organs of 
special -cus,.. Medicines having unpleasant odor or taste are 
taken with difficulty; and even the sight of certain preparations 
is sufficient to cause uncontrollable disgust for the remedy. 

The same organs, through which savory viands and fragrant 
spices produce a pleasurable sensation, also transmit the Impres- 
sion of disgust from unsightly objects and nauseous substances. 

in addition to the rational views of mental influences, enter- 
tained by therapeutist-, strange and inconsistent vagaries are 
indulged, which are not sustained by scientific investigation nor 
practical demonstrations. 

Somnambulism, a state which really occurs, is magnified by 
the marvelous into the power of appreciating objects without the 
exercise of the physical senses. Thus sleep-walkers arc said to 
shun obstructions in their course while unconscious, and witli the 
eyes firmly closed. 

Mesmerism and table-tipping arc terms used to denote the 
reputed psycological control possessed by some persons over the 
mental and physical actions of others, and even of inanimate 
substances. The latter of these so-called sciences is said to invest 
the operator with even the superhuman faculty of calling up, 
and consulting at pleasure, the spirits of departed friends ! These 
pretenders have even led their deluded and over-credulous fol- 
lowers into the ridiculous belief that, from the potency of their 
will, disease is cured, as if endowed with miraculous power. 

These things are too ridiculous to merit even a passing notice; 
yet, that there are some electrical, nervo-psychical manifestations, 
not satisfactorily accounted for, on any known principle of chemi- 
cal or psycological science, is altogether probable. Experimental 
investigation of these mysterious influences has yet to shed more 
light on this subject, before it is properly understood. The simi- 
larity of nervous power to electricity, in at least some of its 
manifestations, has already excited in the minds of investigators 
the conjecture of their identity. 



SOMATICAL REMEDIES. 7 

SOMATICAL REMEDIES. 

Somatical Remedies — from <jco/m, the body — exert their 
action upon physical structures, and are, hence, also called cor- 
poral remedies. They consist of all material agents, and may be 
divided into pharmacological and mechanical, or surgical. 

Pharmacological substances are such as are capable of 
undergoing preparation according to the rules of pharmacy. It 
may be said that they are made up principally of agents having 
appreciable weight, and hence called ponderable; but of those 
that are imponderable — light, heat and electricity — heat is used 
in such manner, and is so essential in the operations of pharmacy, 
that it may, with propriety, be classed amongst those subject to 
pharmaceutic preparation. The same may be said of electricity. 
Both, therefore, have their appropriate places in the list of 
medicinal agents, and will be found on the following pages, in 
the classes to which they properly belong. Light, not having a 
place amongst pharmacological remedies, will be considered only 
as a hygienic agent. 

Physical Remedies include all the surgical and obstetrical 
appliances used in these departments of the healing art, respect- 
ively; and for an account of them the reader is referred to works 
on these subjects. Surgery, however, in common with the prac- 
tice of medicine and midwifery, requires most of the pharma- 
ceutic preparations. Indeed, they are as indispensable to the 
successful practice of the art, as v the mechanical means used 
exclusively in it. 

Drugs, from Dragan, to dry, are crude substances from 
which medicines are prepared by the pharmaceutist. Their 
botanical or chemical and commercial history; their sensible 
and medicinal properties, and pharmaceutic preparations, come 
within the province of the pharmacologist. Not only so, but 
even their collection and preservation are appropriately con- 
sidered by him. 

Medicines are the preparations of drugs for the dispensing 
apothecary. This term is limited in its signification, and does 



X /LCOLOGT. 

not include all remedies. Medicines include preparations only, 
of material pharmacological agents; remedies embrace every 

variety of means used to palliate or cure disease. 

HYGIENE. 

It is the business of acologists to describe the agencies l>v 
which health is preserved, as well as those to restore it when 
lost, 

HYGIENE — from 'jyesea, health — teaches the manner of pre- 
venting disease; and the means consist of mental as well as 
material influences. 

Exercise of all the organs is necessary to their natural vigorous 
condition. Mankind should always be employed. The accom- 
plishment of some object, requiring exercise of the mind as well 
as body, should be engaged in constantly, in order to general 
activity. The invigorating effects of mental enjoyment, upon the 
nervous and other systems of the body, are unmistakable. The 
varied scenes and pleasant associations brought to bear at fash- 
ionable watering places, are well understood by practitioners, 
who advise their wealthy patrons to seek the enjoyment of such 
visits. The benefits are realized without regard to chemical 
constituents of the water. Whether mineral, thermal, or other 
variety, the salutary influence is the same, while the true secret 
of success tbrever remains as a sealed book to the subject, The 
benefit is, of course, ascribed to the medicinal virtues, tempera- 
ture, etc , of the waters. 

Mental stimulus afforded in this manner, and by other methods, 
leads to more regular and healthful exercise, and thus, indirectly, 
becomes tonic to the muscular and other systems of the body. 
The awakening of lively sensations by these means gives zest 
and appetite for the amount of food necessary to sustain the body, 
which would not otherwise be relished. 

Moreover, the mental attractions presented in picturesque 
scenery tempt the delicate and over-cautious from their haunts of 
seclusion into the bracing air and sunshine, so important to the 
proper vigor of the whole organism. 



HYGIEN& 9 

Besides these, psycology affords other instances in which restor- 
ative as well as hygienic advantages are found in mental 
influences. 

From the foregoing definition of hygiene, any means used for 
the preservation of health may be included under the general 
system, whether corporal or mental. Some of those acting upon 
the mind, and through it upon the physical structures, have been 
noticed. The direct effect of material agents for this purpose 
may also be considered. 

Light, incidentally mentioned in connection with the names 
of imponderable material agents, and, though not properly be- 
longing to any of the classes arranged for this work, plays, 
nevertheless, an important part in the perfection and preservation 
of health and vigor. 

It is a well known fact that vegetable growth is always imper- 
fect without the influence of the sun's rays. The frail and sickly 
plant, raised in a shady position, compares unfavorably with that 
in a more exposed situation. Not less so is the pale, feeble and 
delicate child, carefully kept within doors, contrasted with one 
who has the good fortune to be the object of less irrational solici- 
tude. The colorless cheeks of those spending the day-time in a 
darkened room, give unmistakable evidence of a want of vigor 
in the peripheral circulation. A white skin is secured in this 
way, at the expense of strength, sprightliness and vivacity. 

The constitution of man was not designed, mushroom-like, to 
grow and flourish in the dark, and wither into a sickly inactive 
state under exposure to light and heat. At early morn, the skin 
is more or less shriveled and pale. Mental and physical languor 
exists. This gives place to flow of spirits and bodily activity, 
after the sun's reviving influence has been received. 

Air. — The tonic, bracing effects of atmospheric air, beyond 
that received by oxygenation of the blood in respiration, cannot 
be denied. Air is the medium, also, through which the poison of 
infectious and epidemic diseases are transmitted, and its freedom 
from noxious substances is, of course, essential to salubrity. As 
a hygienic measure, therefore, it is necessary to ascertain its state 
of purity in this respect at any given locality. 



1<> AtiOLOGtf. 

The debilitating effects of confined air, in which the oxygen 
has been partially exhausted, is made to appear when a large 
number of persons remain lor some time in a dose room, or when 
the air is respired over and over again until the quantity of 
expired carbouic acid gas becomes insupportably large. 

These facts being known, the avoidance of localities where the 
air is infected, and of confined situations where the oxygen does 
not maintain its healthful proportion, is a hygienic precaution 
that should not he neglected. 

The noxious effluvia emanating from slowly subsiding stagnant 
pools which have been rilled during the summer months, from 
the washing of fresh, fertile soil, is productive of disease. Xo 
chemical test has yet detected this malarious poison; and it is 
only by its effects in the production of disease that the existence 
of this subtle morbific agent can be determined. Whether or 
not it exists in the form of algoid spores, as supposed by some, 
the condition of things necessary to its production, and the gene- 
ral rule governing its transmission through the atmosphere, are 
understood. Exposed situations in the neighborhood of such 
production must, of course, be abandoned during the "ague 
season/' in order to avoid the disease. There is no purifier of 
such atmosphere but Time, and there are no means of preventing 
the production except by reduction of the temperature, entirely 
drying the pool, or deeply submerging substances within it. Tem- 
perature above 75° is said to be necessary for the production 
of malaria, and where it does not exceed this degree, as in 
portions of California, intermittent fever is unknown. 

Animal effluvia, arising from the subjects of infectious and 
contagious disease, is transmitted through the air, carrying with 
it the germ by which the same disease is propagated in others. 

Pure, invigorating air, uncontaminated by such productions, 
may be found in mountainous, uncultivated sections where 
Nature's purifier flourishes undisturbed. There it is that oxygen 
in abundance is exhaled from vegetable growth, and a limited 
amount consumed by animal respiration. Unlike the sites of 
crowded cities, the invigorating influence of pure air is readily- 
perceived by those coming from a less salubrious region. 



HYGIENE. 11 

WatEr, when taken into the stomach as a diluent, or necessary 
beverage, has no special connection with hygiene. Investigation, 
however, with a view to determine the wholesome qualities of 
this fluid in particular localities, conies properly within its 
domain. The idea prevails in some communities that malarial 
fever is produced by water taken into the stomach. This, how- 
ever, is fast giving way to more rational views on the subject. 

The improper use of water as a beverage, like all errors in 
taking food or drink, may lead to unpleasant consequences and 
even violent disease. Excessive draughts of cold water while 
the body is exhausted from heat and fatigue, may disturb the 
equilibrium of the circulation, and lead to serious congestion and 
disease of some vital organ. From this cause the stomach itself 
my be subjected to violent spasmodic contraction, giving excessive 
pain for some time. Even fatal results have been known to fol- 
low its imprudent use in this way. 

Ablution, or bath, with water at a temperature to suit the 
circumstances and condition of the person, is an indispensable 
sanitary measure. A healthy condition of the skin, so important 
to the comfort and wellbeing of all, is promoted by this means. 

The remedial properties of water, and the manner of using it 
for different purposes, will be given, in connection with other 
articles of the classes to which it properly belongs. 

Exercise is essential to health from various considerations. 
It has a place in a class of curatives, and is mentioned now only 
in connection with its use as a hygienic means. This, as well as 
other agencies intended for the preservation or restoration of 
health, and even those essential to life itself, used in excess, leads 
to unpleasant results. Exercise is not an exception to this gene- 
ral rule. Muscular movement is necessary, not only to the 
healthy and active condition of this system itself, but also to the 
digestive and other organs whose functions are essential to life 
and health. When violent and long-continued, however, the 
effect is opposite to that desirable. Evidently, man is constituted 
for the regular and temperate exercise of the mental as well as 
physical organs. Employment, which gives exercise in proper 
degree and time of duration, is not less essential than rest when 



12 Ecology. 

the organs have been over-taxed. The mere gratification of the 
appetites does not fill the purposesof our creation, and, therefore, 
not adapted to our physical structure. Ennui, restlessness, 
lethargy, etc., are the result of sedentary habits, and give evidence 
of functional, and the liability to organic, disease. Regular 
physical exercise, therefore, cannot be suspended for any length 
of time with safety to the digestive functions, while the usual 
amount of food is taken. The internal organs are adapted to the 
jolting and constant agitation to which they are subjected in 
prosecuting the common avocations of life; and, although con- 
stant habit, gradually introduced, may finally change, to some 
extent, the physical tendencies, yet disease is apt to follow a vio- 
lation of these natural laws. 

Sleep is the temporary suspension of certain functions. This 
rest of the organs concerned, is not only necessary to their own 
healthy condition, but that of the whole body. 

The cerebrum, whose active operation constitutes the mind, 
requires regular periods of rest. This, to the extent of destroying 
consciousness, is called sleep. Thought, the active exercise of 
our mental faculties, requires rest, even more than that derived 
from sleep. Relaxation from intense study is, therefore, found 
necessary while awake, in order to keep up the activity of these 
powers. 

The amount of sleep necessary for mental and physical invig- 
oration varies according to the amount of exercise taken. Bodily 
fatigue renders more sleep necessary than that of the mind; and 
young persons require more than those of mature age. Laborers, 
as a general rule, should sleep eight or nine hours in the twenty- 
four, while six or seven are sufficient for those of sedentary occu- 
pations. Frequent variations from this requirement of Nature, 
entail upon offenders the evil of hygienic error, depraved health. 

Diet is an important hygienic means, and is also an essential 
consideration in the treatment of many diseases. Redundancy 
and deficiency of food are alike injurious; and the quality is of 
prime consideration in the selection to suit particular cases. The 
appetite, or desire for food and drink, if unbiased by the habit of 
excessive indulgence, and other circumstances, is Nature's measure 



PHABMACY. 13 

of the amount necessary to be taken. Epicurean indulgence, 
however, in savory viands, prepared with inviting and stimulat- 
ing condiments, so modifies the natural instincts that a proper 
limit of supply is materially changed. The consequence of 
excessive quantity or indigestible quality, taken into the stomach, 
is a failure in appropriating the nourishing ingredients, from a 
want of proper digestion. In this way, full diet of rich food 
may not only fail to give nourishment, but prove a source of 
embarrassment and depression to the whole economy. 

There are many circumstances which make the desire for food 
unequal to the amount required. The physician's judgment 
should then control the amount and quality used, though it should 
prove disgusting to the patient. 

Drinks, which temporarily excite the nervous system, and 
through it the digestive organs, are often used injuriously, and cor- 
responding depression is likely to follow. It may, therefore, be 
said that the unnecessary or excessive indulgence in drinks, which 
are highly useful in certain morbid conditions, as temporarv 
stimulants, is prejudicial to health, and sometimes lays the foun- 
dation for mental, moral and physical ruin. 

PHARMACY. 

In the operations of Pharmacy, as connected immediately with 
preparations for the dispensing apothecary, the manner of col- 
lecting, selecting, preserving and manufacturing for commerce 
and the use of druggists, is not directly concerned. All, how- 
ever, come legitimately under the notice of Pharmacologists. 

The purity and efficiency of drugs are greatly dependent on 
the manner of collecting and preservation, where vegetables are 
concerned, and in the observance of a definite system in the 
manufacture of mineral productions. 

In the collection of vegetable substances certain rules must 
necessarily be observed, in order to secure that efficiency of action 
which the article is capable of affording. Not less essential in 
this respect is their proper preservation. Many vegetable pro- 
ductions collected at the proper season, and selected with care, 



14 ACOLOGY. 

may be rendered inert and useless from the failure to observe the 
rules for preserving. Certain varieties of articles require a very 
different course of management from that of others, in the modes 
of preserving as well as collecting. Some are volatile in their 
nature, while others are not; some bear well the sun's heat and 
exposure to the air for an indefinite time while drying; other- do 
not. Thus, it will be seen, that upon the manner of collecting 
and preparing of drugs, the efficiency of their preparations, in a 
good degree, depends. The Pharmaceutist should be sufficiently 
familiar with their sensible properties to determine from the ap- 
pearance of specimens, whether they have undergone the proper 
course of management to preserve their medicinal properties. 
Without this information, judicious selections cannot be made. 
The same may be said of inorganic substances. Certain evidences 
of correctness in their manufacture should be well understood, in 
order to insure the usual medicinal virtues. 

COLLECTING, not only requires care in removing dirt, other 
extraneous matter and impurities, but the rejection of decayed, 
dry and inactive portions. Moreover, in order to insure perfect 
activity of the article, certain rules, as to the season, state of per- 
fection, etc., should be observed. 

Roots should generally be collected when the plant has attained 
to its greatest perfection. Annual roots are in the most perfect 
state when the plant has arrived at its full growth, and before the 
leaves begin to wither, either from the natural limit of its growth 
or the approaching season of frost. Biennials are said to afford 
more perfection in the quality of their roots during the second 
year, and at this time, with the precaution above-mentioned for 
annual plants, they should be collected. 

Perennials afford sufficient maturity after the first year of their 
growth, and during autumn, after the leaves have withered, the 
roots may be obtained. 

In order to the preservation of roots they should, when suc- 
culent and of sufficient size to require it, be cut into transverse 
pieces to facilitate the drying. Generally, a few days' exposure 
to the sun and air will preserve them sufficiently to prevent 
mouldiness and decay. Artificial heat is sometimes necessary, in 



PHARMACY. 15 

order to hasten the drying, particularly in damp weather, when 
the process would otherwise be too long delayed for their preser- 
vation. 

Leaves should always be collected when of full growth and 
before the period of decay. They should be gathered free from 
stems or branches and other impurities. The drying can usually 
be effected in the shade, with or without artificial heat, according 
to the state of the atmosphere. Exposure, on hurdles, to a free 
current of air, occasionally stirring, will be sufficient in dry 
weather. When properly dried, leaves retain their bright green 
appearance, to some extent, and in order to this the drying pro- 
cess must sometimes be hastened by artificial heat. This is best 
effected with stoves in the drying room, by which the tempera- 
ture can be readily raised to any required degree, say 90° to 100° 
Fahr. The same plan is applicable in the collection and drying 
of herbs, tops or branches, with their leaves. When the stalks 
or branches are not large, the drying may be more easily accom- 
plished, and with less stirring, as they are not so compact as the 
leaves alone. 

Feowers may be gathered when full blown, and before the 
petals commence falling. The same general rules for leaves will 
apply in drying flowers, except that more care and expedition 
are required, on account of their greater delicacy and the volatile 
character of their medicinal virtues. 

Bark, from the trunk or root, requires that the scurf or dark 
outer portion be removed, and the pieces cut or broken into con- 
venient size for drying and packing. As a general rule, bark is 
best obtained at that season when it is most readily separated 
from the wood. The summer, for that taken from the trunk ; 
and winter, for that from the root, will be found most convenient. 

The drying is accomplished in the same manner as with roots. 
In dry weather, no further trouble is necessary than the exposure 
to the sun for a few days. Should damp, cloudy weather super- 
vene, however, the drying room becomes necessary to complete 
the process. 

Seeds are not in a condition for use until thoroughly matured, 
and the time for their collection is generally indicated by the ten- 



L6 ACOLOGl 

dency to waste. They arc sometimes sufficiently dry for preser- 
vation when collected. Exposure to the sun, or to the tempera- 
ture and air of a drying room is, however, generally necessary, 
in order to insure them against mouldiness and deterioration in 
other respects. 

Packing is an important consideration in the preservation of 
drugs. In the first place, vegetables of any kind should be 
thoroughly dry when stored away. They should, also, l>e pro- 
tected from moisture by being kept in dry, airy room-. Some 
varieties of plants are affected by light; and, in the packing, due 
regard should be had to this fact. Boxes, barrels and earthen 
vessels are, therefore, preferable to glass. Exposure to the air 
beyond that necessary to bring them into a proper state for pres- 
ervation, is injurious to many vegetable productions. Not only 
to prevent the evaporation of essential principles is it necessary 
to avoid exposure, but to prevent the injurious effects of moisture, 
with which it is often loaded. For these reasons, in packing such 
substances, where they are to remain for any considerable length 
of time, they should be guarded in this respect. For protection 
against insects, it is also necessary to pack in closely covered, 
and sometimes impervious vessels. Various means have been 
suggested for the destruction of worms and other insects, which 
seem to result from ova deposited on the vegetable before or 
during the preparation for packing. Camphor, chloroform, etc., 
are said to be effectual in some instances. 

Drugs pass through various forms of preparation for their 
more perfect preservation, and convenience of transportation in 
commerce. This business is conducted by the wholesale general 
dealer, situated so as to receive crude articles from countries in 
which they are found, and make them a commodity of traffic. 
Extensive manufactories have been established for this purpose, 
in Europe and America. In these, their bulk is reduced by sep- 
arating extraneous substances and inert portions. Crude articles 
are thus brought into the forms of powders, extracts, etc. From 
articles in this state, pharmaceutic chemists obtain, separately, 
the active ingredients of certain vegetable substances containing 
alkaloid and other active principles. 



WEIGHTS AND MEASURES. 17 

Foe these purposes, and for the manufacture of inorganic pre- 
parations, extensive chemical laboratories, with reagents, etc., are 
brought into requisition. 

Drugs require to be weighed in their commercial transfer; also 
in making pharmaceutic preparations and in dispensing. Hence, 
certain established tables of weights and measures are in use for 
these purposes. In the sale of drugs the same weights are used 
as in other commodities, the Avoirdupois pound of 16 ounces; 
but for the use of pharmaceutists and dispensing apothecaries, 
the U. S. Pharmacopoeia adopts the Troy pound of 12 ounces, 
and its divisions. 

The British Pharmacopoeia, now authoritatively fixed as the 
standard for the Dominions of Great Britain, recognizes tables 
differing materially from these. Much confusion arises, in the 
international exchange of medical literature from this, and the 
entirely different nomenclature and value of French weights and 
measures. Below will be found tables of all these standard 
weights and measures, with their relations to each other: 

WEIGHTS AND MEASURES OF THE U. S. PHAR- 
MACOPOEIA WITH THEIR SYMBOLS. 

TROY OR APOTHECARIES' WEIGHT. 

1 pound lb i =12 ounces % xij 

1 ounce 5 i = 8 drachms 5 viij 

1 drachm 5 i = 3 scruples 9 iij 

1 scruple Si =20 grains grs. xx 

The wine gallon and its divisions are used by pharmaceutists 
and apothecaries, in preparing and dispensing medicines. 

WINE OR APOTHECARIES' MEASURE (ll. S. D.) 

1 gallon C i = 8 pints O viij 

1 pint O i =16 fluidounces . . . . f § xvi 

1 fluidounce f §i = 8 fluidrachms. . ..f 5 viij 

1 fluidrachm f 5 i —60 minims min. lx 

Approximate measures, sufficiently accurate for dispensing 
ordinary medicines by physicians, will be found in every house- 
2 



18 ICOLOGY. 

hold. These are often necessarily brought into requisition, par- 
ticularly in the country, where practitioners have often to perform 
duties properly belonging to the apothecary. Such utensils and 
their capacities are as follow: 

An ordinary glass tumbler contains about eight fluidounces; 
a teacup, tour fluidounces; a wine glass, two fluidounces; a 
table spoon, half a fluidounce; a dessert spoon, two fluidrachms; 
a tea spoon, one fluidrachm. 

The capacities of these vessels vary so frequently that, in their 
use, no absolute certainty is arrived at. When of usual size, 
however, they approach the amounts specified, sufficiently near 
for ordinary purposes. 

A drop of average liquids is about one minim, but the size 
varies according to the density and other characteristics of 
the fluid, and nature of the vessel from which it is made. 
Some liquids, volatile in their character, and whose particles 
have very little cohesive property, form drops containing not 
more than half a minim, while those of the opposite qualities 
make at least two minims to the drop. Vessels with large 
mouths and thick edges form much larger drops than will be 
made from a vial with thin lip. 

In Great Britain the troy pound of 12 ounces is used, but, 
unlike apothecaries' weight in the United States, is divided into 
pennyweights instead of scruples and drachms. The pound, 
ounce and grain have the same value as those of this country. 

WEIGHTS AND MEASURES OF THE BRITISH 
PHARMACOPCEIA (Pereira.) 

•TABLE OF WEIGHTS. 

1 pound ft). =12 ounces =576 grains. 

1 ounce oz=20 pennyweights. =480 grains. 

1 pennyweight dwt.= 24 grains. 

1 grain gr.= 1 grain. 

MEASURES. 

1 gallon C. =8 pints . . O viij 

1 pint O. =20 fluidounces fl. oz. xx 

1 fluidounce fl. oz. =8 fluidrachms. . . .fl. drs. viij 

1 fluidrachm fl. drm.=60 minims min. lx 



WEIGHTS AND MEASURES. 19 

The following tables, prepared from the French recognized 
weights and measures, are introduced in order to show their rel- 
ative value with those of the United States: 

The livre (16 onces) is indicated by the sign Sb 

The once (8 gros) " " " § 

The gros (3 scrupules) " " " . .5 

The scrupule (24 grains) " " " . ., .3 

The grain " " " g 

FRENCH DECIMAL AND METRICAL WEIGHTS—THE RELATIVE 
VALUE OF EACH, AND THOSE OF THE UNITED STATES. 

FRENCH WEIGHTS. tX S. WEIGHTS. 

Decimal Weights. Metrical Weights. Troy Weight. 

ft) S 5 3 g lb S 5 3 grs 

10 centigrammes=l decigramme=0 1.84=0 1.53 
10 decigrammes =1 gramme =0000 18.40=0 000 15.30 
10 grammes =1 decigramme=0 2 1 16.00=0 2 1 13 
10 decigram mes=l hectogramme=0 3 11 16.00=0 3 11 1 
10hectogrammes=l kilogramme=l 15 7 1 16.00=2 7 7 

In the above table exactness is observsd in the comparative 
value of each system, but the French Codex tolerates a variation 
from this, for the sake of convenience. In the following recog- 
nized practical estimates, only an approach to accuracy is obtained. 
The gramme, for instance, is set down as the equivalent of 18 
grains French, when, in fact, as is seen in the above table, its 
true value is a little less than 18 J. The kilogramme is con- 
sidered equal to two livres, when, really, it lacks more than 
thirty grains. 

5 centigranimes=l grain. 

2 grains =1 decigramme. 

18 grains =1 gramme. 

4 grammes =1 gros. 

8 gros =1 once. 

16 onces =1 livre. 

2 livres =1 kilogramme. 



20 ECOLOGY. 

RELATION OF MEASURES TO WEIGHTS OF THE BRITISH PHAE- 
MACOP03IA, ( PEREIRA.) 

1 gallon =The measure of H> pounds of water. 
1 | > i lit The measure of 1.25 " u 

1 fluidounce =The measure of 1 ounce " 

I fluidrachm =The measure of 54.68 grains " 

1 minim =The measure of <>.91 " " 

RELATION OF BRITISH TO METRICAL WEIGHTS, (PEBEIRA.) 

1 pound=453.5925 grammes. 
1 ounce = 28.3495 grammes. 
1 grain = 0.0648 grammes. 

RELATION OF BRITISH TO METRICAL MEASURES, (PEREIBA.) 

1 gallon =4.543487 litres. 

1 pint =0.567936 litres. 

1 fluidounce =0.028396 litres. 

1 fluidrachm =0.003549 litres. 

1 minim =0.000059 litres. 

FRENCH MEASURES AND THEIR RELATION TO THOSE OF THE 
UNITED STATES. 

FRENCH MEASURES. U. 8 HBA8UKE8. 



1 hectolitre =100 litres =24 gallons. 

1 litre or pinte= 2 setier or chopins= 2 pints. 
1 setier = 4 poissons = 1 pint. 

1 poisson = 4 roquilles = 4 fluidounces. 

RELATION OF FRENCH TO U. S. LONG MEASURE. 

METRICAL MEASURE U S. MEASURE. 



1 metre =100 centimetres=3.28 feet. 
1 centimetre= 10 milimetres =0.39 inch. 

In the above table of French and United States measures, 
only an approximation to accuracy is claimed. The loose man- 
ner in which metrical and decimal weights and measures are 
reckoned, renders precision in these tables unnecessary, were it 
possible to arrive at it. 



PHARMACEUTIC CJtfEMtSTRV. ±[ 

PHARMACEUTIC CHEMISTRY. 

Material agents are composed of organic and inorganic sub- 
stances. The former arc derived from animal and vegetable 
productions, the latter from the mineral kingdom. 

Bodies are either simple or compound, and in order to deter- 
mine their character in this respect, as well as properly to pre- 
pare many of them for use, a knowledge of chemical laws and 
manipulations is necessary. 

A .simple body is that which cannot, by the most rigid scrutiny 
with chemical tests, be reduced to more simple elements, or be 
made to change its character — only in mere form — except by 
combining with some other substance. 

Elementary or simple bodies are of three kinds: aeriform, fluid 
and solid. Of the former, oxygen, hydrogen, etc., are represen- 
tatives, while iron, sulphur, mercury, and other metals and 
metaloids belong to the latter varieties. In the progress of 
chemical discovery the list of simple elements is being constantly 
increased, and now contains the names of about sixty-five arti- 
cles. These unite with each other, and with compound bodies, 
forming simple, double and tripple compounds, in accordance with 
fixed laws. The power by which such combinations are made is 
called chemical force or chemical affinity. This differs materially 
from the law of physics, by which the particles of homogeneous 
substances are held together, called cohesion or cohesive attrac- 
tion. 

Bodies have physical and chemical properties, by which they 
are known and made to answer the useful purposes for which 
they are employed. 

Consistence, color, evenness of surface, etc., are sensible or 
physical properties, with which their chemical constitutions have 
nothing to do. Chemical properties are seen in the relation they 
sustain to, and the reaction produced in, other simple or com- 
pound substances, when brought in contact. Iron, under favora- 
ble circumstances, is known to unite with oxygen, forming a 
compound, differing, in many particulars, from either of the 
constituents, yet the two elements exist in a changed state, and 



22 ACOIAHW. 

on being again separated, each exhibits its characteristic chemical 
properties. 

Malta- is indestructible; but a change of state destroys the 
features by which it is known physically, so long as it thus re- 
mains. In such changes, with many substances, all the chemical 
and sensible properties are lost during the new state. For exam- 
ple, in the production of a salt, by the union of an acid with a 
base, both ingredients forming the compound, lose their identity. 
The salt does not exhibit the characteristics of either. 

SynthesiH — the combination, or union of elementary or com- 
pound substances, so as to form new compounds — is that which 
chiefly occupies the attention of pharmaceutic chemists. By it 
remedies are made to assume different and much more useful 
forms, and thereby, not only change their chemical and sensible 
properties, but, in some instances, their medicinal virtues. 

Analysis — the separation of elementary or other ingredients in 
combination — enables chemists to examine the components of 
substances, obtain a knowledge of their properties, and select or 
reject them, as may be desirable in forming medicinal compounds. 

Elementary bodies are represented by symbols, in giving for- 
mula3 of their combinations. Usually, a capital of the first letter 
in the Latin name is used for this purpose. In some, the second 
letter also; as O for oxygen, and Se for selenium. 

These elementary principles unite with each other in definite 
proportions called chemical equivalent, and upon this is founded 
the theory of atomic weights. The relative weight of the lowest 
combining proportion of each substance in combination is ob- 
tained, and this number represents its atomic weight. Combina- 
tions occur in different absolute amounts, but always in fixed 
relative proportions. They unite in the proportions of 1 to 1, 2, 
3, 4, etc. Thus, the equivalent number, or atomic weight of 
hydrogen, the lightest elementary body, is taken as 1. Oxygen, 
whose lowest combining proportion weighs 8 times as much, has 
8 for its atomic weight. If 1 atom each of oxygen and hydro- 
gen unite, the sum of their atomic weights will be, oxygen . 
8, and hydrogen 1=9. This is the atomic weight of water, a 
compound of the lowest combining proportions of these elements. 



PHARMACEUTIC CHEMISTRY. 23 

In formulae, showing the constituents of these compounds, 
when more than one atom of cither arc used, it is denoted by a 
small figure immediately following the symbol, as in the formula 
for bichloride of mercury, Cla Hy., which signifies two equivalents 
of chlorine and one of mercury. 

When a large figure precedes the symbol, it is understood to 
govern all that follow, to next comma or -J- sign. A bar through 
or under the symbolic letter, has the same signification as the 
figure 2 after each. When a symbol stands alone, it is under- 
stood to represent one equivalent. 

A table of the sixty-five elementary substances, with their 
symbols, and equivalent or atomic weights respectively, will be 
found in works on Chemistry. 

Besides the weight of combining proportions or atoms of the 
simple elements, their volume is also ascertained. The volume 
of hydrogen, whose atomic weight is 1, is double that of oxy- 
gen, whose combining weight is 8. Water, the result of a com- 
bination of one equivalent each of these two elements, has, when 
in the state of vapor, about the same volume as the amount of 
hydrogen entering into the composition. 

A peculiar nomenclature is adopted by chemists and pharma- 
ceutists, in which the name of a preparation or compound, indi- 
cates the ingredients entering into it, and the amount of each. A 
knowledge of this is indispensable, not only to the chemist, phar- 
maceutist and dispensing apothecary, but to the prescribing 
physician. The principal feature of this system consists in pre- 
fixes and terminations to the name. The termination ide to the 
name of the nonmetalic or metaloid element, indicates the Binary 
compound, made by the union of two elementary bodies without 
the presence of acid. The terms, oxide of zinc and chloricZe of 
mercury indicate the union of these simple substances, respect- 
ively. Combinations with cyanogen, a compound radical, are 
also named in the same way ; as, cyanide of potasium, etc. 

Acids are of two kinds; in one oxygen, in the other hydrogen 
forms the acidifying principle. Oxacids differ in the amount of 
oxygen they contain. The highest degree of oxidation is denoted 
by the termination ic; when containing a less amount, ous; as, 
sulphuric acid and sulphurous acid. 



SM AOOtOGY. 

Hypo — from urro, under — prefixed, as %/>osulphuric acid, In- 
dicates a little less than the usual quantity of oxygen, but still 
enough to authorize the termination in ic. 

Tli/per — from uxep, above — is applied in the same way, to de- 
note an excess of oxygen. The same prefixes are \\>vi\ also for 
the weaker acids ending in ous, and for the salts of both. 

Wydraeids are those which obtain their acid property from 
hydrogen, and have but one degree of acidification. These also 
have the terminal, ic, and are known by the prefix hydro, as 
hydrochloric acid, hydrocyanic acid, etc. 

When a compound is formed by the union of either an oxacid 
or hydracid with a base, the name of the resulting salt, not only 
indicates the acid and the base, but also the degree of acidifying 
property in the former. Thus, salts made from acid ending in 
ic and ous terminate in ate and ite ; as, sulphate of sodium, sul- 
ph//r of potassium, when sulphuric and sulphurous acids are u^vd. 

Not only are the ingredients composing different salts made 
known in chemical nomenclature, but also the relative quantity 
of each. 

Bi, a contraction of the Latin bis, two, and tei-, three, are pre- 
fixed to denote the equivalents of acid, when more than one is in 
combination with one of the base. For salts in which the base 
predominates, di and tri, contractions of the Greek o:^ and to-:-, 
are used when two or three equivalents or combining proportions 
of the base are united to one of the acid, as r//acetate of lead, 
///nitrate of bismuth. 

Per, in reference to oxygen, for example, is a prefix that shows 
the oxide to contain the highest number of equivalents with which 
one equivalent of the base will combine, without regard to the 
number of atoms. A bichloride is, therefore, a perch loride when, 
as with mercury, two atoms of chlorine is the highest number that 
will combine with one of the metal. 

Proto — from -ow:o;, first — has been used as a prefix to denote 
the first degree or lowest combining proportion of oxygen, etc., 
with a base, as jorofoxide, ^rofochloride, etc. 

Scsqiii, signifying one and a half, is used to express the fact 
that the acid and base unite in the proportion of 2 to 3, assesguv- 



MECHANICAL OPERATIONS. 25 

oxide, sesgtwsulphate, etc., denoting that two equivalents of the 
acid or acidifying principle unite with three of the base in the 
formation of the salt thus named. 

MECHANICAL OPERATIONS OF PHARMACY. 

In addition to chemical laws, by which the operations of 

pharmacy are conducted, certain rules must be observed, in order 
to effect the mechanical changes necessary to the thorough pre- 
paration of remedies. Some of these have already been alluded 
to in connection with the selection and preservation of drugs. 
We shall now notice briefly some of the contrivances, and rules 
for their use, by which mechanical alterations are made, render- 
ing the drug capable of being administered as a medicine. Me- 
chanical operations of various kinds are absolutely necessary, in 
many instances, for the effectual play of chemical affinities in the 
formation of compounds. Powders, solutions, etc., must neces- 
sarily be made of solid substances, before their particles, in suffi- 
cient numbers, can be brought in contact with the reagent 
intended to form chemical combinations. 

Definite terms are used to designate the various processes, and 
the forms of preparation which result from their operation. 

Pulverization is effected by different means, according to the 
nature of the substance to be acted on. Grinding by mills of 
stone or iron, or between rollers, is the most effectual mode of 
bringing certain substances into the form of powder. Trituration 
or pounding by mortar and pestle, is also used for this purpose. 
Those substances, which are dry and friable, may be easily 
reduced by grinding; others require pounding, rubbing, etc. 
When other materials are added to assist in the process, it is 
called mediate pulverization, as, in the preparation of Dover's 
powder, the sulphate of potassium, a hard salt is added, so that the 
other ingredients may be more readily pulverized and thoroughly 
mixed. 

Contusion — or bruising between rollers or by pounding with 
mortar and pestle — renders the particles of solid musses accessible 
to liquids, without being reduced to the state of powder. Fresh 



26 iCOLOGl 

roots, barks and herbs arc treated in this way, in order to the 
action of liquids upon them, for the solution of their active prin- 
ciples, and also for the more ready expression of oils or juices 
from them. 

Special terms are applied to the processes for obtaining a solu- 
tion of the medicinal ingredients of solid vegetable substances. 

Maceration is the immersion of a heterogeneous solid, bruised 
or coarsely powdered, in a liquid at the ordinary temperature of 
the atmosphere, to remain the required length of time for the 
solution of its active principles. 

Digestion involves a similar process; carried on at an increased 
temperature, say 100° Fahr. This additional heat is necessary 
to the perfect solution of the active ingredients of some vegeta- 
bles, while it is not in others. Hence, in making liquid prepa- 
rations of certain drugs, it is important that artificial heat he 
kept up during the proeess of solution. 

Solution is the mechanical incorporation of the particles of 
solids between the globules of fluids, without destroying the 
solvent's transparency. Unlike chemical combinations, both the 
solid and liquid retain their original properties. Water, alcohol, 
ether, oil, etc., combine in this way with certain ingredients, and 
that fluid which thus unites with a particular article, is said to 
be its solvent. The pharmaceutic terms applicable to these 
forms of solution, are made in accordance with the name of the 
solvent and the substance dissolved, and are known as " Liquors" 
under the head of " Pharmaceutic preparations/' 

ElutHation is a term applied to the process of separating solids 
from each other, by sifting, etc. The finer particles of powdered 
substances are thus separated from the coarser. 

Fluids may be separated from solids by various processes: 

1. Expression is a convenient mode for obtaining oils and 
juices from fruits and from bruised vegetables, after having im- 
bibed liquids during the process of maceration or digestion. 

2. Filtration is the proper mode, when solids, in the form of 
fine powder, are to be separated from fluids intended for use. 
Miters of woolen cloth, paper and sand are made for this purpose. 



MECHANICAL OPERATIONS, 27 

Charcoal is also useful in this way, and particularly so when the 
absorption of ammoniacal gases, or other putrescence, is desirable. 

3. Decapitation — pouring off' — effects this object when the solid, 
though finely powdered, is of sufficient specific gravity to subside 
perfectly. Fine particles in liquids, which are not heavy enough 
to precipitate, may be rendered so by — 

4. Despumation, or the clarifying of fluids by adding albumen 
in the form of isinglass, white of egg, etc., which, meeting with 
and adhering to the solid particles, subsides or rises to the top in 
the form of scum. 

Percolation or lixiviation is a short process for dissolving the 
active principles of vegetable substances, and separating the 
liquid from the solid portions, answering the purposes of mace- 
ration and nitration. This process is accomplished by moistening 
thoroughly the powdered drug with a portion of the solvent, and 
after remaining ten or twelve hours in this state, the mass is 
placed in a percolator, and the remaining liquid poured upon it. 
The liquid with which the powder was first moistened, having 
dissolved the active principles to saturation, is driven off by the 
fresh liquid, and passes through a filter attached to the Percolator 
in the form of clear solution. Tinctures are readily made in 
this way, and the process is termed displacement. 

Vaporization is the change of liquids to the aeriform state, by 
the application of heat. Substances not volatile in their charac- 
ter, dissolved in liquids and exposed to vaporization, remain in 
the vessel after the liquid is driven off, and are thus separated 
from their solvent. 

Evaporation is the change of liquids to vapor, by exposure in 
shallow vessels to the air, without artificial heat. 

By these processes of vaporization, dissolved ingredients are 
separated from their solvent, and the juices of plants are reduced 
to a state of dryness, making solid extracts. The latter is called 
inspissation or exciccation. Opium is the inspissated juice of the 
poppy ; manna, of the ornus Europsea, etc. Evaporation in the 
open air and sun is generally sufficient for such preparations, but 
when solid or fluid extracts are made from solutions of the active 
principles of plants, in water or alcohol, artificial heat is applied 



28 AC0LOG1 . 

in order to hasten (lie process. Sand, water or steam bath is 
ased for these purposes, in order the more easily to regulate the 
temperature. This is necessary to prevent a degree of heat 
injurious to the preparation, which is likely to occur after evapo- 
ration has measurably ceased, on account of the increase of tem- 
perature above the boiling point. 

OrystaMzation results from the vaporization of certain solutions. 
When solid bodies, subject to the crystaline formation, are dis- 
solved or changed to the state of fumes, their particles arrange 
themselves it) definitely shaped masses, on returning again to the 
solid form. By their particular forms, the crystals of many 
substances arc readily recognized. There are some, however, 
whose crystals are found in two forms. These are termed dimor- 
phous, while those substances having crystals of the same shape — 
which is the case with a few — are called isomorphous. Those 
which cannot be made to assume the crystaline form at all, arc 
termed amorphous. 

Crystals are formed, as has been stated, from fumes, which are 
the result of sublimation; and from solutions of crystalizable 
substances by evaporation. In the former process, solid particles 
are formed by the fumes condensing on the sides of the vessel or 
retort ; in the latter, by the solvent being driven off in the form 
of vapor, while the ingredient dissolved is left to crystalize. 

Distillation is a process by which liquids are separated from 
each other, and includes some of the same principles involved in 
sublimation and vaporization. To separate any fluid from one 
less volatile than itself, the mixture is placed in a retort or still, 
and heat applied, so as to vaporize the fluid more easily changed 
to the aeriform state. Refrigeration is, at the same time, applied 
to the worm or stem, so as to condense the vapor into liquid. In 
this way essential oils, alcohol, etc., may be separated from their 
watery connections. 

Distilled water is obtained by subjecting ordinary spring, well 
or river water to this process, thereby ridding it of salts and 
other impurities which it contains in solution. These remain in 
the retort, while pure water passes over, in the form of vapor, 
into the condensing apparatus. 



FORMS OF PREFARATION. 29 

FORMS OF PREPARATION. 

Tin: forms in which medicines are dispensed vary according to 
the nature of the remedy, the purpose for which it is intended 
and the part of the body to which it is to be applied. They 
differ in their consistence and are divided into 

1. Solid preparations intended chiefly for internal administra- 
tion, either by the mouth or rectum. These consist of 

(a) Pilfc, which are globular masses, made of convenient size 
for swallowing. Some medicinal substances are of proper con- 
sistence and tenacity for ready preparation into pills, without the 
addition of other ingredients, but generally some tenacious sub- 
stance is necessary to preserve their rotundity. For important 
practical reasons, the adhesive article should be selected with due 
regard to the length of time the pills are to be kept, and the 
manner of preserving them. When intended for immediate use, 
crumb of bread or gum arable, with a little water, is all that is 
necessary; but, when to be kept for a length of time, if prepared 
in this way, they are liable to become dry and hard, so that they 
are not sufficiently softened by fluids in the stomach to have the 
desired effect. On the other hand, if prepared so as to keep 
moist, and should not be properly cared for, they become mouldy, 
and deterioration of the medicinal ingredient is the result. 

The great improvements in the art of pharmacy, not only as 
respects the separation of the active principles in vegetables from 
inert and sometimes injurious portions, but in preparing them for 
use, furnish the means of preserving pills for any length of time. 
This is done by a coating of sugar or gum, which protects them 
from the effects of air and moisture, and at the same time is 
readily dissolved in the stomach. Moreover, the substances with 
which they are coated being of agreeable taste, much difficulty in 
the administration of remedies is thereby avoided, making it 
desirable that they be thus coated, even when to be used at once. 

Convenience of administration is the chief advantage derived 
from this form of preparation. Indeed, remedies administered 
in this way are less speedy in their action, than when given in a 
state of solution or otherwise, favoring prompt absorption from 
the stomach. 



oO ACOLOGY. 

(J>) Powders constitute a form of preparation in which sub- 
stances have been reduced to minute division, by triturating, 
grinding, etc., as has been mentioned already in connection with 
the mechanical operations of pharmacy. This is not a form in 
which medicines arc often administered, but in which they are 
subjected to other extemporaneous preparation- before being taken. 
Of these we shall have occasion to speak hereafter. Medicines of 
which pills are to be made, when not already in this form, require 
to be pulverized in order to prepare the mass. Thus, it is clear 
that pulverizing is intended more for convenience in preserving 
and making other preparations than for immediate administra- 
tion. 

(c) Lozenges or Troches are composed of a solution of sugar, 
gum or tragacanth in water, incorporating such medicinal sub- 
stances as are desirable to be taken in this way, and evaporated to 
a solid consistence. When sufficiently firm they are cut into any 
desirable shape that convenience or fancy may dictate. This 
form generally contains substances intended to impress the throat 
and air passages, by the preparation slowly dissolving on the 
tongue. The mucous membrane of the mouth and throat is 
soothed by demulcent ingredients, and also the respiratory tube, 
through a supposed sympathy of continuity. In this way 
demulcent and anodyne substances are thought to allay irritation 
of the larynx, trachea, and even the bronchia, upon which 
troublesome cough sometimes depends. 

Anthelmintic, and other remedies intended for internal use, 
may be prepared in this form, for their more ready administra- 
tion to children. By this preparation the taste of unpleasant 
remedies may be, in a measure, concealed, and the preparation 
taken without inconvenience. Hence, various medicinal sub- 
stances, not required in large quantity, are used in this form. 

Troches, containing opiate, astringent, demulcent and aromatic 
ingredients are officinal preparations in the United States. 

(d) Sv/pposUories, intended principally to evacuate the bowels 
by the mechanical stimulus they afford, may incorporate sub- 
stances designed to effect a special local action. Any solid sub- 
stance introduced into the rectum for either of these purposes, is 



FORMS OF PREPARATIONS. 31 

called a suppository. A piece of soap made into a conical form, 
and of the proper size for introduction into the bowel, answers 
well as an evacuant of the lower portion of the intestines. The 
advantages of producing catharsis by solids or fluids introduced 
into the rectum, are found in the promptness with which they 
act, and the certainty of not producing excessive evacuation. In 
the formation of suppositories containing: opiates, astringents, etc., 
for their special action upon the mucous membrane, soap, 
tallow or spermaceti answers as an excipient. The quantity 
introduced into the rectum, whether solid or fluid, when intended 
to remain and impress the mucous membrane, should be small, 
as a large amount is more likely to be rejected, by the contraction 
its presence excites in the bowel. 

(e) Plasters are solid preparations, intended for external appli- 
cation, and are composed of substances requiring to be heated or 
moistened, in order to their adherence. Wax, resin, litharge, 
gum, etc., incorporating such substances as are intended to make 
particular impressions on, or through the skin, form plasters. If 
iutended only for protection and support to injured parts, they 
contain nothing except the demulcent and adhesive substances. 
Thus prepared, the mass is heated or moistened to the consistence 
which will allow it readily spread on cloth or leather. When 
applied, moisture or artificial heat, according to the excipient 
used, is necessary to render the plaster sufficiently adhesive for its 
application. 

(/) Solid Extracts, like "powders," are not in a form for 
administration without further preparation, but are mentioned as 
forming solid masses, from which extemporaneous preparations, 
such as pills, etc., may be readily made. 

2. Liquid preparations make up a large proportion of the 
forms for internal administration. The operations of Pharma- 
ceutic chemistry, in the separation of vegetable alkaloids, and 
the manufacture of innumerable chemical compounds of vegetable, 
mineral and animal substances, cannot be fully considered in the 
limits of this work. It has been astertained, by experiments, in 
what proportions, and length of time, saturated solutions can be 
made without waste of the solid or liquid material ; and Phar- 
macopoeias give exact formulae for reference. 



32 IC0L0G1 

In making any of the fluid preparation- from heterogeneous 
vegetable substances, they should be contused or powdered, so 
that the solvent may come in contact with every portion of them. 

Very tine powders, however, do not best elleet this object. They 

become firmly Impacted at the bottom of the vessel where they 
naturally subside, so that frequent agitation is accessary to expose 

all the solid particles to the liquid for its full action in making 
the solution. Substances, therefore, thoroughly bruised, or in 
coarse powder, arc preferable to the same, in the form of very 
minute division, for the preparation of tinctures, decoctions, etc. 

The solutions of medicinal ingredients, or their active princi- 
ciples, are named in accordance with the liquid engaged and the 
process used. 

(a) Tinctures. This term is understood to denote that form of 
preparation in which alcohol, diluted alcohol, ether or aqua 
ammonia is used as the menstruum. Most tinctures, however, are 
made with alcohol or diluted alcohol. Some are made of sub- 
stances whose active ingredients are not wholly soluble in alco- 
hol alone, but require .the addition of water in order to perfect 
solution. 

Two processes are in use for their preparation, viz.: maceration 
for fourteen days, and percolation, by which the object is accom- 
plished in as many hours. The comparative value of these 
modes of reducing crude vegetable substances to the form of 
tincture, depends upon various circumstances connected with 
their preparation. When ample time ean be allowed without 
inconvenience, the old process of keeping a definite proportion of 
the remedy immersed in the menstruum for one or two weeks may 
be adopted. On the other hand, when expedition is sought, and 
the ingredient is capable of being properly pulverized, much 
time may be saved, and an equally active 1 tincture obtained, by 
the system of percolation or displacement, and sometimes by diges- 
tion instead of maceration. Percolation, however, has been 
adopted by the standard of this country, as decidedly preferable, 
for most of the tinctures. 

In this form, medicines are not only more perfectly preserved 
from deterioration, but much more speedily produce their impres- 



FORMS OF PREPARATION. 33 

sion upon the system. While solids require more or less time to 
dissolve, soften or become mixed with fluids in the stomach, so 
as to be absorbed, preparations in the liquid state, particularly 
such as volatile tinctures, are readily taken up by the veins. 

(b) Decoctions are made by boiling, in water, such substances 
as yield their virtues to it by this process. It is only when 
intended for immediate use, or for additional processes, whereby 
other preparations are formed, that decoctions are made. They 
cannot well be preserved for any considerable length of time, 
particularly in warm weather, owing to their tendency to fer- 
ment. The active principles of certain vegetables are soluble in 
water at the boiling heat, that are not so in this fluid when at the 
ordinary temperature of the atmosphere, or even above it. The 
solution, however, remains permanent after becoming cool. 
Decoctions, therefore, may be used at any temperature found 
most convenient and useful, in every respect. Certain articles, 
whose active properties depend upon essential oils, or other vola- 
tile ingredients, are not subject to this form of preparation. 
Cinnamon, cloves, sassafras, etc., are of this kind, and if subjected 
to boiling heat, would not retain the volatile oils upon which 
their activity depends. 

(c) Infusions may be made of those vegetable substances, whose 
medicinal ingredients are soluble in cold or moderately warm 
water. Even boiling water may be poured on such as contain 
volatile principles without dissipating them; as the temperature 
rapidly falls below the point at which they escape. This prepa- 
ration is made by macerating or digesting the vegetable remedy 
in water for a short time, and is intended only as extemporaneous 
form for immediate administration. 

(d) Wines are solutions of substances, or their active principles 
in the liquid giving name to the preparation. Several varieties 
of wine are used for this purpose; but Teneriffe, Madeira and 
Sherry are preferred. Vinous preparations are not always per- 
manent, owing to changes sometimes produced by principles 
abstracted from vegetable or other substances which lead to 
acetous fermentation, etc. Wine, however, has advantages, as a 
solvent, in some respects. Many articles do not yield their vir- 

3 



■ \\ ACOLOGT 

tucs readily to alcohol, unless largely diluted; and as wine con- 
tains it in this state, becomes a suitable menstruum for such 
remedies. 
The same processes, in the main, are in use <dr making wines* 

as those mentioned for the preparation of tinctures. Several 
medicated wines are officinal, and are used sometimes in prefer- 
ence to tinctures, on account of their containing less alcohol in 
the dose required. 

(e) Vinegars, or, as sometimes called, medicated vinegars, are 
made of such vegetable and other ingredients as readily dissolve 
in vinegar. Diluted acetic acid, or distilled vinegar, is used in 
order to avoid the impurities of ordinary vinegar. The advan- 
tages of acetic acid, as a menstruum arc, first, that vegetable 
alkaloids readily combine with it, making mild acetates, and at 
the same time, not materially affecting their medicinal properties; 
and secondly, their admissibility in prescriptions for disease in 
which alcoholic preparations are contra-indicated. 

The recognized authority of the United States adopts about 
the same processes in the preparation of vinegars as those for 
tinctures and wines. . Percolation is employed almost exclusively 
now, instead of the tedious process of maceration. 

(J) Solution* are barely entitled to a place amongst pharma- 
ceutic preparations, belonging more properly to the extempora- 
neous forms for immediate administration. The various soluble 
salts, etc., are usually administered in solution, but are not kept 
for any length of time in this state. Until recently, the United 
States Pharmacopoeia did not recognize solutions in water, as a 
class of pharmaceutic preparations, but mentioned them only in 
connection with the general description of certain preparations, 
giving the proportions to water in which they are soluble. A 
late edition, however, authorizes a distinct clas n which formulae 
are given for "liquors" or ".solutions." In these are found the 
simple and compound salts of iron and other metals, etc., made 
from the elementary substance in the form of watery solution. 

3. Semifluid preparations are intended for internal use, as well 
as external application, and named according to the ingredients 
of which they are composed, and the parts of the body for which 
they are intended. 



FORMS OF PREPARATION. 35 

(a) Syrups are composed of a solution of sugar in water, and 
contain medicinal agents. 

Simple syrup consists of a concentrated solution of sugar, and, 
when medicated, is named in accordance with the ingredient 
entering into its composition. 

Syrups are so prepared as to retain the medicinal agent perma- 
nently in solution. Some remedies, soluble in water, may be 
introduced with the sugar, and both dissolved with or without 
artificial heat, as may be required. Decoctions, infusions, and 
even tinctures may be changed into the form of syrup by dis- 
solving sugar in them to a proper consistence. 

For the preparation of simple, and the various officinal medi- 
cated syrups, formulae, giving the proportionate quantities, will 
be found in Pharmacopoeias and Dispensatories. 

(6) Cerates are soft-solids and intended for external application. 
They are usually prepared of wax, balsams and other unctuous 
substances which afford sufficient adhesiveness, and, by the tem- 
perature of the skin, are sufficiently softened to adhere readily in 
the coldest weather. Cerates may incorporate medicinal agents 
intended to impress the skin itself, or even to affect parts beneath; 
but more frequently they are used to protect the denuded or 
otherwise injured surface of the body from the atmosphere, etc. 

Wounds and ulcers are generally protected in this way, and 
sometimes require anodyne or catheretic action, which can be 
effected by combining with the cerate such remedies as fill the 
indication, without destroying its protecting influence upon the 
denuded surface. Cerates, like plasters, are spread upon cloth, 
leather or charpie, according to the part upon which they are 
used, and the object of their application. 

(c) Ointments are less firm and consistent than the preceding 
preparation, ana also intended for external application. They 
are composed of oily substances, or combinations of these with 
alkalies, making saponaceous compounds, with which are asso- 
ciated such medicinal agents as may be usefully applied in this 
way. Ointments are either rubbed upon the skin, or applied by 
means of a cloth, covered or saturated with the preparation. 



36 LCOLOGY. 

They contain substances intended to impress internal parts by 
being absorbed from the skin, or to affect the integument itself 
as an emolient or counter-irritant. 

[d) Liniments Sire preparations still more fluid than the form 
last named; but, like them, generally contain oily substances 
together with the medicating agent. Their application is also 
sometimes made by saturating a cloth, bul most frequently by 
friction, so as thoroughly to imbue the surface with the prepara- 
ration. They are generally u^ed for their counter-irritant, ano- 
dyne and emolient effects. 

(e) Lotions are liquids impregnated with the substances medi- 
cating them, by solution or otherwise. They are applied in the 
same manner, and for the same purposes, as ointments and lini- 
ments; and, also, as refrigerants, when volatile. 

PARTS OF THE BODY TO WHICH MEDICINES 
ARE APPLIED. 

The manner of introducing remedies, or the particular part 
to which they may be most advantageously applied, is an im- 
portant consideration in Therapeutics. From caprice, location 
of disease or peculiar conformation, it is sometimes found im- 
practicable to administer medicines in the way usually preferred. 
There are those who find it impossible to swallow a pill, even 
in ordinary health, owing to some slight unfavorable variation 
from the usual structure or sensibility of the throat. Others, 
either fail to swallow or eject them immediately after taking into 
the stomach, certain articles having very disagreeable taste. 

1. The Stomach, on account of the facility with which absorp- 
tion occurs from it, is the great receptacle for a majority of rem- 
edies, intended to affect the animal economy through their elective 
influence, after being absorbed and carried into the circulation. 
In this way they are more readily introduced in quantities re- 
quired, and in forms which would not be taken into the circula- 
tion from other parts of the body. As elective remedies are 
absorbed and enter the blood vessels before their action is exerted, 
those introduced into the body in a solid form must, necessarily, 



FARTS OF THE RODY To WHICH MEDICINES ARK APPLIED. 37 

be dissolved before they can he taken up by the veins or other 
absorbent vessels. Substances insoluble in water are often found 
to exert their usual influence when introduced into the stomach ; 
which can be accounted for only on the presumption that the 
proper solvent is met with in that organ. Mild chloride of 
mercury is insoluble in water and alcohol, and, yet, its elective 
effects are generally manifested promptly when taken into the 
stomach. The same may be said of quinine and many other 
valuable medicines. 

The secretions of this viscus have remarkably solvent powers, 
dissolving alike principles in the food, which differ widely from 
each other, and the various medicinal agents that are insoluble 
in many other liquids. Some of them, no doubt, pass through 
the ordinary stages of digestion as do articles of food. 

Furthermore, the abundant supply of nerves, distributed to the 
alimentary canal, and their numerous connections with those 
furnishing other organs, favor this mode of introducing remedies 
affecting the nerves directly, if impressions be thus made without 
their having entered the circulation. 

2. The Rectum, though inferior in every respect as a point for 
the application of remedies, is frequently substituted for the 
stomach, not only in the use of medicines, but food also. Ab- 
sorption from this part, however, is comparatively imperfect; so 
much so, indeed, that even when administered in solution — a 
form most readily taken up — it is necessary to introduce triple 
the quantity required in the stomach. Fluid diet, in a condition 
to be absorbed without the full process of digestion, may be used 
in this way, so as to prevent death from inanition, which, under 
certain circumstances, may otherwise occur. In violent organic 
disease of the stomach, by which its functions are totally 
destroyed, and in certain forms of nervous disturbance, causing 
.the immediate rejection of food when swallowed, nourishment 
administered in this way, may be made to answer the purpose of 
support. 

Mechanical influences, and agents intended to act locally on 
disease of the part, are advantageously applied to the bowel 
directly. The increase of peristaltic motion, by the introduction 



38 ACOLOGtf. 

of any solid or fluid substance is notorious. It is l>v such 
mechanical influence that catharsis results from the injection of 
any fluid in considerable quantity, or the insertion of a solid 
substance into the rectum. 

Moreover, the excitement thus produced extends above that 
portion containing the substance, through the sympathy of con- 
tinuity, or by reflex nervous impression. 

3. Tlic Skin is a part to which applications are made in order 
to their direct local action upon the surface itself) and for the 
transmission of remedial agents into the circulation. Counter- 
irritation is thus effected, by which the condition of internal 
organs is modified. In the establishment of a new point of irri- 
tation, internal vascular and nervous disturbance is allayed, on 
the principle of M irriUdio ibi fluarus. 

Remedies introduced through the skin for their elective 
influence upon parts to which they are carried by the circula- 
tion, are conveyed with facility equal to that of any other mode 
of administration, when of suitable form. 

There are three modes by which medicine is transmitted to the 
circulation through the skin : 

(a) Epidermic — from eire, upon, and oeoujj.. the skin — is a mode 
by which the remedy is placed on the cuticle, and through it 
transmission of the remedy into the circulation occurs. On parts 
of the body least exposed to external influences, such as the arm- 
pits, inside of the arms, thighs, etc., the cuticle is thin, and from 
these absorption is more active. At best, it takes place to a 
limited extent through the epidermis, and scarcely at all, when 
the skin is irritated by the remedy. 

(6) The Endermie — from eu, in, and depfxa, the skin — is a plan 
of introducing redemies, which requires that the cuticle be re- 
moved by blistering or otherwise, so that the application may be 
made to the true skin. From this, absorption goes on more 
rapidly; and the salts of morphia, cVrc, applied to a recently de- 
nuded surface, dissolve in the moisture present, and are readily 
taken into the circulation. In this way the anodyne or other 
effects of the remedy will be speedily felt throughout the system. 
The usual quantity required by the stomach is not sufficient 



PARTS OF THE BODY TO WHICH MEDICINES ARE APPLIED: 39 

when u§ed in this way, unless the whole amount applied should 
be dissolved and taken up by absorption, which is not very 
probable. 

(c) Hypodermic application — from otto, under, and dsp/jta, the 
skin — has of late attracted the attention of therapeutists, and is 
already a popular mode of administering certain remedial agents. 
Syringes for this purpose are in common use, and various reme- 
dies are thus administered in preference to any other way. The 
advantages claimed for it are, that owing to the rapidity of ab- 
sorption from the subcutaneous cellular tissue, the action is more 
speedily induced, and the occasional unpleasant effects upon the 
stomach avoided. For administration in this way, remedies re- 
quire to be perfectly dissolved, lest unpleasant irritation result 
from solid matter beneath the skin, which cannot be absorbed, 
leading to abscess, &c, as other foreign substances. 

Preference is given to this mode of medication, also, on account 
of the advantages supposed to arise from the introduction of 
remedies in the vicinity of local disease. If this be a correct 
conclusion, it stregthens the opinion that certain remedies act 
directly upon nerves, to some extent, without entering the circu- 
lation. 

The opinion that more permanent effect is realized from the 
hypodermic use of neurotics, than other modes of administra- 
tion, as promulgated by recent investigators, needs confirmation. 
The advantages above alluded to, however, enable the practi- 
tioner to continue their use much longer, without detriment to 
the digestive process, and thereby to gain more complete and 
permanent control of troublesome nervous affections. 

This is, by far, the most useful mode of introducing remedies 
through the external surface of the body; and when the article 
is soluble in water, and can be used effectually in small quantity, 
is decidedly preferable to administration by the stomach or rectum. 
The dose is about the same as when used by the mouth. 

4. The Nose is sometimes made the receptacle for medicines, 
through which they readily make their impression upon the sys- 
tem. Absorption promptly takes place in the pituitary mem- 
brane, and finely pulverized soluble salts, and other substances 



10 LCOLOOt. 

in this state, may be conveyed t<» the circulation through this 

surface, and are carried into the nares by the process of snuffing. 

Facial neuralgia, influenza and cephalalgia, are sometimes 

promptly relieved by the salts of morphia used in this way. 

5. T/n Lungs till an important agency in the production of 
general anaesthesia. It is remarkable with what promptness and 

efficiency anaesthetics produce their effect when inhaled, while do 

such result follows their introduction into the stomach. Does 
this difference in the effects by the two modes of administration 
depend upon the difference in quantity entering the circulation, 
in a given time, owing to the greater rapidity with which it 
reaches the brain from the lungs? Agents enter the lungs in 
the form of gas, vapor, fumes and spray, hut only in solids and 
liquids are they used by the stomach. Nitrous oxide gas may he 
readily introduced into the alimentary canal, and the question, 
whether remedies in the same form, absorbed from the stomach 
and lungs, will produce similar effects, may thus be definitely 
' settled, if doubt exists. 

The above applications of remedies to various parts of the 
body are mentioned in connection with their absorption and 
transmission through the circulation to the organs for which they 
have affinity, or upon which they act electively. All these parts 
are subject to local disease, and may require direct applications 
for their cure. Many such affections are successfully treated, 
only by local remedies. The lungs and air passages are not 
exceptions, but give decided proof that general or elective treat- 
ment is utterly useless in certain chronic diseases. Remedies are 
taken into the lungs for their local effect, in the liquid form, by 
insufflation; in the forms of fumes, vapor, spray and sometimes 
powder, by inhalation. 

Remedies are also used for local diseases of the mouth, and, 
when in the liquid form, are called coUutoriex. 

To the nose, remedies are applied for their local action; not 
only with the view of correcting a diseased state of the interior 
surface, but also to excite the membrane, when healthy, to 
increased secretion, as a means of local depletion and counter-ir- 
ritation. These are called errhines. 



TARTS OF THE BODY TO WHICH MEDICINES ARK APPLIED. 41 

Washes, for the conjunctiva when inflamed or otherwise dis- 
eased, are called collt/ria. 

The skin, vagina, uterus and urethra also require such local 
action of remedies, sometimes, as the only means of successful 
treatment. 

Local remedies intended to cure disease, by coming directly in 
contact with it, are applied by various modes according to the parts 
affected. Whether solid or liquid, they may be applied in the 
concentrated state, or diluted in the forms of solution, cerate, 
cataplasm, etc. 

In order to impress diseased mucous membranes lining the 
vagina, uterus, urethra, bladder and respiratory tubes, mechanical 
contrivances are necessary. These vary to suit the particular part 
involved. The syringe, by which the vagina may be injected with 
facility, would not carry the medication into the uterus. Different 
plans are adopted for the latter purpose; the principal of which 
are, the probe, tent and uterine syringe. 

Instruments are in use for the application of solid and fluid 
preparations to the urethra and bladder. For the former, the 
port caustic has been a favorite, while an easy and convenient 
mode of using fluid preparations is that of injecting the remedy 
through a catheter carried down to the affected part; and in this 
way any portion of the urethra or neck of the bladder may be 
effectually impressed. 

The respiratory mucous membrane can be affected more per- 
fectly with local remedies by inhalation. While the fauces and 
larynx may be successfully treated with the spray of atomizers, 
and the nares with washing by the spritze, yet the bronchia can 
be thoroughly and safely reached only by inhaling the remedy. 
Fumes, impalpable powder and vapor are the forms in which reme- 
dies are used in this way, and will be considered in connection 
with the use of catheretics, in bronchial and nasal affections. 

The plan of injecting liquid preparations into the large bron- 
chia, proposed, and said to have been practiced pretty extensively 
some fifteen years ago, is extremely hazardous, and has been 
abandoned. 

The introduction of remedies into the stomach is often intended 



VI LCOtOGl 

solely to atlect diseased portions of the :i 1 im«iit:»r\ canal by 
contact wit 1 1 them. 

The form of preparation, under such circumstances, should be 
suited to the particular portion intended for Its action ; e. g. if the 
stomach i> to be impressed, fluid preparations are, perhaps, pref- 
erable, but it' the diseased part be lower down, absorption will 
probably prevent its reaching the diseased point. Pills, when 
hard and dry, are more likely to come in contact with disease 
thus situated. 

The stomach may be impressed by these ordinary forms of 
preparation, but in order to more perfect local action, the pump 
is recommended. In a paper from Dr. Sehliep, read before the 
Clinical Society of London, recently, the results of washing out 
the organ with various medications by the stomach pump, were 
very satisfactory. While the instrument was tested more partic- 
ularly in dilatation of the viscus, the report justifies its use in 
other forms of disease. In this way the stomach may be washed 
out and local remedies applied and removed without allowing 
unnecessary absorption. In order to avoid the supposed diffi- 
culty of drawing portions of the mucous membrane into the 
tube, he suggests the insertion of a short piece of thin rubber 
tubing, between the pipe and the pump, so that easy collapse of 
the rubber will prevent any considerable force on the stomach. 
{Medical and. Surgical Reporter.) 

Doubtless this mode of applying remedies, for their action upon 
the gastric mucous membrane, will be found efficient in the treat- 
ment of chronic inflammation of this surface. The most tormenting 
dyspepsia is that dependent upon chronic gastritis, characterized 
by red tongue, thirst, burning sensation, pain, etc., after taking 
exciting food. With the pump catheretic remedies can be applied 
for such length of time only as is desirable. 

Another, and still more simple mode of introducing fluids 
into, and discharging them from, the stomach has been proposed. 
A kind of syphon is formed, by attaching four feet of india rub- 
ber tubing to a stomach pipe; fill them with water, and hold the 
end of the rubber tube till the stomach pipe is introduced, then 
lower the tube so that its contents and the fluids of the stomach 



MODUS OPERANDI OF REMEDIES. 43 

may flow out. When this is effected, place the end of the tube 

in water or other liquid, and raise the vessel above the patient's 
head, stripping- the air from the tube, so that the stomach may 
receive 1 the contents. In this way the organ may be emptied and 
tilled at pleasure. (St. Louis Medical and Surgical Journal, 1870.) 

MODUS OPERANDI OF REMEDIES. 

The physiological action of remedies, and the changes thereby 
effected in diseased parts, called therapeutic results, are subjects 
deplorably neglected in medical education. 

To practice successfully any branch of the profession, their 
study is indispensable. The tempting tendency to learn only 
the therapeutic uses by rote, is a sad difficulty in the progress of 
rational medicine, and leads to the empirical idea of specifics for 
the cure of disease. Under this facinating delusion the names of 
remedies and the diseases to which they are applicable, are care- 
fully studied, to the exclusion of their special properties — their 
physiological action. 

Medicines, as well as poisons, affect particular organs or tis- 
sues to the exclusion of others. Opium acts on the brain, 
strychnia on the spinal cord, and turpentine on the mucous mem- 
branes. These are specific or elective physiological actions, and 
are produced in health or disease. If used in quantities beyond 
the point of prudence and safety, the effect is called poisonous; 
if in debility of these parts, and to the extent only of restoring 
the normal activity, the result is therapeutic. 

Again, if some organ or part becomes the subject of derange- 
ment, in consequence of inactivity of the brain, spinal cord or 
heart, and should be relieved by restoring such controlling cen- 
tral organ to its normal condition, the result is direct in giving 
relief to the radical disturbance in the brain, but indirect toward 
the consequential derangement. In a fit of muscular spasm, 
originating in nervous perturbation, for example, the painful 
contractions, &c., are relieved by the calming effect of increased 
nervous influence sent out from the nervous centre, under the 
exciting action of opium or other cerebral or spinal stimulants; 



11 U50L0G*. 

the neurotic acting physiologically upon the brain or spinal cord, 
and giving this indirect therapeutic result in the muscular 
teni. To this we shall more Billy allude hereafter. 

The question, whether all remedies affecting the nervous sys- 
tem, enter the circulation before doing so, has elicited no small 
amount of investigation. Headland, in his work on "The Action 
of Medicine," discusses this subject thoroughly, and arrive- at 
the following conclusion: No influence is transmitted to the 
centres along- the nerves with which the remedy come- in contact; 
but, in order to impress the brain or spinal cord, it must first be 
absorbed and taken into the circulation. In proof of this posi- 
tion, he gives the experiments of Magendie, Brodie, Blake and 
others upon animals, in which it was found that the nerves of a 
limb, into which woorari was inserted, were not necessary to its 
action on the nervous centres, but that the veins are indispensable. 
Experiments on this subject seem to prove conclusively that the ar- 
ticles used make their impression on the brain, to the extent of very 
decided action, only by being taken into the circulation. This 
docs not prove, however, that no impression is made upon the 
nerves themselves, which are distributed to the part where the 
poison is applied. The nerve may be acted on, and its function 
to some extent modified, without transmitting to the centre suffi- 
cient influence to produce in it symptoms of the elective poison- 
ous effect. That the nerves of a part are, to some extent affected 
in this way, seems to be proven by the soothing effect of opium 
applied to structures in an irritable and painful condition. It 
is thought that when thus used, the control exerted is more 
speedy and effectual than when otherwise administered; and, 
yet, there is, perhaps, no transmission of effect along the nerve to 
the brain. The very speedy development of convulsive move- 
ment, from placing a few drops of prussic acid upon the tongue 
of a cat, allows an almost incredibly short time for the absorp- 
tion and entire round of the circulation. This, however, is met 
by the assertion, founded on the experiments of Dr. Blake upon 
larger animals, that substances make the entire circuit of the cir- 
culation in nine seconds. As the circulation of a cat would 
probably require still less time, the few seconds necessary to de- 



MODUS OPERANDI OF REMEDIES. 45 

velop symptoms of poisoning by prussic acid may be sufficient 
for the brain to receive it in this way. 

From the present state of progress in these investigations, it 
is perhaps safe to conclude that remedies making decided im- 
pression upon the nervous centres, do so by direct contact ; that 
the substance is carried thither through the circulation ; and that 
the nerves distributed to the point of introduction are affected 
by it ; yet, it is not likely that speedy and powerful impressions 
are made through them upon the centres, as some have supposed. 

It has been stated that the physiological action of remedies 
depends on specific or elective affinity for an organ to the exclu- 
sion of others. Why it is that this preference exists is not satis- 
factorily determined. Theories have been promulgated on this 
subject, but not being sustained by verified facts, probably should 
be considered as useless conjecture. One suggestion is, that the 
remedy having molecules corresponding, in some of their physical 
properties, with those of the structure acted on, so changes the 
molecular arrangement of the living tissue, by the affinity thus 
existing, that its functions are modified. While this is, perhaps, 
plausible enough, facts are wanting to sustain it. 

Attempts have been made to ascertain the physiological action 
of substances by their sensible properties, and the botanical 
characteristics of plants from which they are obtained; but, 
while, in some instances, a similarity in some respects between 
articles having the same medicinal properties has been discovered, 
yet in a large majority there is no resemblance whatever. 

The salts of salicin and quinia, for example, have the same 
medicinal, and similar sensible properties, but sulphate of copper 
and sulphate of zinc — almost identical in medicinal virtues — 
have no physical resemblance at all. Again, sulphate of mag- 
nesium and oxalic acid, having similar sensible properties, differ 
widely in their effects upon the system. Moreover, in the botan- 
ical order solanacire, in which striking physical resemblance of 
plants exists, the inocuous esculent is found alongside of the 
most virulent poisons. 

According to the plan of this work there are two organs or 
grand divisions of remedies, viz. : local and elective. 



in ICOLOGY. 

Local R* medies make their impression on a part by being placed 
in contact with it. Substances applied to the skin, in order to 
affect that integument itself, are said to act locally, and are called 
local remedies. Medicinal agents are also introduced into the 
stomach for their topical effects upon its surface; as in the useof 
astringents and demulcents, when the mucous membrane of this 
visens requires their impression. r I nns it will he seen that elec- 
tive and local remedies may be administered in the same way — 
applied to the same part — but with very different objects. While 
one is intended to be absorbed, the other is designed to affect the 
surface with which it comes in contact. Some articles, such as 
tartarized antimony, have both local and elective properties, im- 
pressing the surface with which they come in contact, and being 
absorbed into the circulation, affect some other organ also. 

Elective Remedies are taken into the circulation in order to 
action upon the organ of their selection. The term applied to 
this grand division or order, indicates a preference for particular 
orsrans to the exclusion of others, and is here substituted 
for the more common names, constitutional, and general reme- 
dies, which convey the erroneous idea of action upon the whole 
body. While many elective remedies act upon several organs at 
the same time, there is, perhaps, no known agent that exerts 
direct influence upon every part. It is true that a remedy which 
acts upon one organ may, through this action, modify every 
structure, but only as a result of the action on a vital controlling 
organ of the body. 

Remedies act through mechanical, chemical or vital process. 

Mechanical process is that through which any substance, by 
coming in contact with a surface of the body, serves to protect it 
from the air, or other irritating causes; or by its uneavenness and 
roughness, tends to irritate or inflame the part. Cerates applied 
to a denuded surface externally, demulcent drinks in gastritis? 
and wheat bran, and pulverized charcoal, in sluggish peristaltic 
movement of the stomach and bowels, all act through process 
purely mechanical. 

Chemical Process is seen in the local disorganization by the 
reaction and play of chemical affinity between concentrated acids, 



MODUS OPERANDI OF REMEDIES. 47 

caustic potash, etc., and the fluids of tissues to which they arc 
applied. In this way, also, changes are wrought in the circulat- 
ing fluid, by remedies intended to modify its quality. 

Vital Process is that in which the capillary circulation or 
vitality is modified, without mechanical irritation or chemical 
combination with the fluids or solids of the part. Astringents, 
rubefacients, &c, act through this process. Also, most of the 
elective remedies affecting solid structures. 

It may, then, with propriety be said, that all physiological 
actions are made either by local or elective remedies; and that 
these actions are produced through vital, chemical or mechani- 
cal process. 

There are two actions of remedies, primary and secondary. 

Primary Action is the first impression, or the first change 
effected in the condition of a part. This may increase or depress 
the function of an organ more or less permanently, but gives 
place to a state differing from it, and also from that condition 
existing previously to the administration of the remedy. From 
the action of some remedies no such second condition ensues, and 
they, therefore, have no secondary action. Most stimulants of 
the circulatory and nervous centres, leave the organs correspond- 
ingly depressed after the primary or exciting effect passes off. 

Secondary Action thus succeeds and is the result of the pri- 
mary. After the exciting effect of opium declines, stupor and 
inactivity ensue. The first action of a cauterant, one of the 
local remedies, is that of unusual excitement, but this is followed 
by less vigor than that which existed before the application, and 
even the death and sloughing of tender structures is sometimes 
found to occur. Thus, it seems that two actions are had by 
local as well as those called elective or general remedies. As 
above described, secondary action seems to be the result of pri- 
mary impression on the same part, and by the same dose. 

The therapeutic results of these physiological actions are called 
direct and indirect. 

Direct Therapeutic Results are found in the part upon which 
the physiological action is exerted. This is seen in diseased 
structures to which local remedies are applied for relief. The 



IS LCOLOG 

action of renal stimulants, a class of elective remedies, also gives 
direct therapeutic results in the sluggish inactivity of the kid- 
neys. The result is, therefore, direct when the physiological 

action is exerted upon the diseased part 

Indirect Therapeutic Results, or curative effects, are brought 
about in organs not acted on by the remedy. Thus, an inflamed 

pleura is relieved by an elective cardiac sedative, acting on the 

heart, and a local counter-irritant affecting the skin. By this it 
will be understood that indirect results are obtained, in disease, 
by remedies acting directly on sound parts. 

Physiologically Speaking, all remedies have direct action-; vet, 

while ipecacuanha, from its elective influence upon the stomach, 
induces the phenomenon of vomiting, the ultimate or therapeutic 
result upon an inflamed pleura, by the relaxing and sedative in- 
fluence of nausea, is by no means direct. When, however, the 
emetic is given to relieve the stomach of oppressive contents, the 
effect is called direct, since the physiological action is exerted 
upon the deranged organ in giving relief. 

Again, mercury, when given to restore normal action in a 
torpid liver, does so by its elective influence upon the organ dis- 
eased, and has, therefore, a direct therapeutic result; but if, in 
consequence of such hepatic derangement, enteritis should exist 
and should subside from this change effected in the liver, by the 
mercury, the curative effect in the bowel is indirect. 

The same may be said of the action of cinchona in the peculiar 
disordered condition of the spinal cord, leading to the develop- 
ment of the phenomena called malarial fever. The relief is 
direct so far as the nervous center itself is concerned , but indi- 
rect in the control exerted over febrile action. 

The local influence of astringents, demulcents, emolients, cau- 
terants, &c., lead to direct results when applied to diseased parts. 
Thus, the action of nitrate of silver in the cure of inflamed mu- 
cous membranes may be said to induce direct results. Other 
local remedies, such as counter-irritants, effect therapeutic changes 
internally, indirectly, as above stated. 

These various terms, denoting the actions and therapeutic 
results of remedies, are unfortunately used differently by different 



MODIFICATION OF ACTION. 49 

authors. Siu'h confusion is likely to embarrass the learner, and 
should be avoided, if possible. 

Dp. Wood, principal author of the United States Dispensatory, 
and one of the best recent works on Therapeutics, uses the 
terms primary and secondary action in the sense which we employ 
direct and indirect therapeutic results. 

No allusion is made in his work to those actions we describe 
as primary and secoiirfa ry, while the direct and indirect thera- 
peutic results are referred to as physiological actions. 

It will be observed, that in the example of opium, given in 
the definition of primary and secondary actions, both are physi- 
ological actions, and have no reference whatever to curative 
effects, while direct and indirect indicate the manner in which 
therapeutic changes are brought about. 

CIRCUMSTANCES WHICH MODIFY THE ACTION 
OF REMEDIES. 

The ordinary action of remedies is varied by many eircu in- 
stances, some of which are not of frequent occurrence, nor of 
sufficient importance to be mentioned under separate heads, in a 
general view of this subject. The following only it is thought 
necessary systematically to consider: 

1. Climate. — This is generally believed to be an important 
influence in the modification of constitutional susceptibility to 
the action ot certain remedies, and to disease. The elective or 
constitutional effects of mercury is supposed to be much more 
readily induced in Northern than Southern latitudes. Hence 
the quantity recommended in New Orleans is much larger than 
in Philadelphia; particularly when the object of its administra- 
tion is to increase the excitement of the liver. The reverse is 
practiced in the use of calorifics. The depressing influence of cold 
climates makes it necessary to use a large amount of animal diet, 
particularly the fatty varieties, in the management of ordinary 
disease, and as a hygienic measure. Low temperature tends not 
only to the development of diseases resulting from strumous 
diathesis, but leads to this unfortunate constitutional conforma- 
tion, where, otherwise, it would not exist. The means, which, 
in Southern latitudes might prove sufficiently invigorating, will 



50 ECOLOGY, 

fail to do so very far North. While this advantage in the treat- 
ment of tuberculous disease Is derivable rrooi warm climate, the 
sole reliance should not be placed in it. Though, in Northern 
latitudes, a greater amount of fatty substances, and other invigo- 
rating means, are strenuously demanded, yet, even in tropical 
regions, they should not be discarded. Many pay dearly tor 
neglecl in this important particular. It is too often the case that 
invalids visiting the South, to cure a consumptive habit, rely 
exclusively upon a change of climate. Cohabitants of the frigid 
zone, who indulge freely in fat meats, are infinitely less subject 
to such affections than those of temperate regions, who sedulously 
avoid contact of pure, bracing air, and the use of such lood and 
medication as above suggested. 

The effects of opium and other neurotics, affecting the brain 
itself, are, to some extent, modified by climate. A tropical sun 
impresses this organ with an amount of excitability which sub- 
jects it to be more readily influenced by such remedies. Hence, 
opium, under such circumstances, is required in smaller quantity 
than in less heated situations. 

Climate, or variations of temperature in the same locality, 
manifestly influence the action of eli mi natives, operating through 
certain emunctories of the body. The skin and kidneys, whose 
depurating office is very much affected by temperature, are, to 
some extent, vicarious of each other. The latter respond readily 
to the action of their elective stimuli, when, from low tempera- 
ture, the skin is contracted and exhalation measurably arrested. 
When, however, the relaxing influence of warm weather upon 
the integument makes easy the cutaneous transpiration, nothing 
short of repletion of the blood vessels with watery ingredients, is 
likely to insure activity of the kidneys. In temperate regions, 
where the cold and hot seasons regularly appear, it will Ix 1 found 
that diuresis increases as the cool season appears; and, to promote 
perspiration, it is necessary to be kept in a warm room, or well 
covered in bed. On the approach of spring the order in the 
functions of these emunctories is again reversed. 

2. Age has a decidedly modifying influence on the effects of 
remedies, independently of the proportionate quantities for differ- 
ent periods of life under the adult age. It is very well known 



MODIFICATION OF ACTION. 51 

that the nervous susceptibilities are more decided in very young 
persons. With less than the usual proportion of neurotic agents, 
therefore, a child may be thoroughly impressed, and, sometimes, 
even unpleasant narcotism may result from the ordinary quantity 
of opium. 

The nervous impressibility at this period of life is proven by 
the convulsions resulting from the irritation of worms and other 
sourees of intestinal disturbance; and, also, by the coma attend- 
ant upon the latter stages of cholera infantum, dysentery, &c. 

Some substances, however, make their impression less perfectly 
on young subjects. Mercurials, for example, often fail to pro- 
duce any perceptible elective effect on children, even in large 
doses. Whether this depends upon a want of susceptibility in 
the parts to be acted on, a deficiency of solvent material in the 
stomach, or a want of activity in the absorbents, is not very 
clear. It is evident, however, that therapeutic changes are 
effected in enteric disease, referable to the improvement in the 
portal circulation by mercurial excitement of the liver, in chil- 
dren. Ptyalism, notwithstanding, is rarely produced by large 
and repeated doses of mercury, even in quantities that would 
inflame the gums of adults. 

In addition to these modifying influences, there is a delicacy 
of all the structures, particularly of the alimentary mucous 
membrane, which forbids the use of irritating cathartics in any 
quantity. Thus, croton oil, gamboge, etc., are not suitable 
cathartics for children. 

So, also, in old age, when the powers of life are waning, and 
the physical structures have lost their tone and vigor, violent 
remedies must be used cautiously. Medicine, which in the 
buoyancy of youth only tends to ally abnormal excitement and 
restrain diseased action, may so depress the vital energies in the 
aged, that hopeless collapse may follow. Circumstances in life, and 
peculiar physical conformation, lead to weakness and irritability 
of certain organs, in advance of others. The kidneys and blad- 
der in some, while the bowels or nervous system in others, give 
evidence of senile debility, before other parts show symptoms of 
decline. In some old persons inactivity of the bowels, and a 
general want of susceptibility to the action of remedies upon 



52 ACOLOGY. 

them, are constant difficulties, dependent upon advanced age. 
The opposite state of these organs exists with others. Excessive 
enteric irritability sometimes Is found, due, perhaps, to sluggish 

circulation through the portal veins, and a consequent capillary 
engorgement of the bowels, in which violent remedies may lead 
to serious consequences. The urinary apparatus is subject to 
similar state- <»t* imperfect functional action, and requires due 
consideration in the application of remedies. 

3. Sex. — Male and female are, in the main, similarly impressed 
by many remedies in common use. While the latter, in her deli- 
cacy of structure, exhibits less strength and vigor of frame, -he 
nevertheless possesses, in many respects, greater power of endu- 
rance than males. This fact was demonstrated by a company 
of emigrants in quest of Western homes, beyond the Rocky 
Mountains, several years ago, who formed an expedition for this 
purpose. The party consisted of males and females, alike exposed 
to extreme suffering from cold, hunger and fatigue. It is stated 
of them, that while, men fell by the way, exhausted from these 
causes, females were found pressing forward, and many of them 
succeeded in reaching a point in the journey where their wants 
could be supplied. 

The greater ability of females to bear up under disease and 
suffering, is often witnessed by physicians. 

Notwithstanding these superior powers, the greater suscepti- 
bility of females to impressions from mental influences must be 
acknowledged. Upon this sex, love, joy, grief, etc., make more 
powerful and lasting impression. 

The same may be said in regard to the effects of many neu- 
rotic medicines. Their nervous sensibilities being more acute, 
the action of such remedies is more prompt and powerful. 

That state of the system, dependent upon the peculiar functions 
of the uterus, in various ways, modifies, not only the action of 
remedies, but the course of treatment to be observed in the cure 
of ordinary disease. The use of ergot, with either sex, under 
certain circumstances, is followed by no perceptible effect, while 
upon the gravid uterus its impression is often prompt and decisive. 
Exciting diuretics, violent emetics, cathartics, etc., with pregnant 
females are decidedly objectionable in the treatment of diseases. 



MODIFICATION OF ACTION 53 

which, under other circumstances, would require such remedies. 

The action of all medicinal agents, whose elective influence is 
exerted upon the uterine system, is modified, not only by the 
sex, but by the particular condition of the womb at the time of 
their administration, as above stated. 

These various modifying influences, dependent on female pe- 
culiarities, exist only, to any considerable extent, between the 
ages of puberty and final cessation of the menses. Besides those 
already mentioned, the general constitutional disturbance inci- 
dent to the commencing and decline of menstruation, must be 
kept in view, during the treatment of ordinary diseases at these 
periods. Remedies, which, at other times of life, and under 
some circumstances at the same period, are expected to produce 
favorable results, must often be withheld at these stages of life. 

4. Idiosyncrasy. — This peculiarity is met with often, and 
sometimes as an embarrassing difficulty in the use of important 
remedies. It is a constitutional variation by which the usual 
action of remedies is prevented. The peculiarity generally con- 
tinues through life, and must always be considered, when pre- 
scriptions are made. Such anomalous manifestations are ascer- 
tained only by experience in the use of articles thus producing 
unnatural effects. The person with whom a remedy is found to 
"disagree" rarely forgets the fact, and his report on the subject 
in subsequent illness should always be duly considered by the 
medical attendant. Cases have come under our observation in 
which serious inconvenience resulted from inattention to what 
was considered a " whim of the patient." 

Opium, administered for its usual anodyne effect, is sometimes 
found to increase the difficulty intended to be relieved. Ipecac, 
which usually produces relaxation, and thereby relieves local 
congestion, spasm, etc., in some persons, brings on suddenly a 
violent paroxysm of spasmodic asthma. 

These peculiar constitutional defects are manifested even 
through the organs of sense. Certain odors, which are not at all 
disagreeable to most persons, produce very unpleasant effects 
upon others; and objects not generally disagreeable, prove dis- 
gusting to some. 

5. Habit— This, as the adage goes, " becomes second nature/' 



5 1 ACOLOGt. 

and truly works Important changes in the susceptibility of the 
system to impressions. Physiological peculiarities, more or less 
permanent, are brought about by a regular course of regimen, or 
medication. These changes greatly influence the action of certain 

remedies. By the habitual use of some remedies, tolerance ofj 
or lessened susceptibility to, their action is induced, while with 
others the opposite is found to result. Cerebral excitants, par- 
ticularly opium and alcohol, belong to the former, while mercury 
and certain emetics are said to increase the irritability of organs 
upon which they act. One who has often been brought under 
the sialagogue effect of mercurials, to the extent of ptyalism, 
requires less of the medicine to renew the impression. So, with 
the daily use use of lobelia, ipecac and tar tar i zed antimony, in 
their emetic effect. This is not, under all circumstances, the 
result, however; for tartar emetic, when given in full doses, and 
repeated every few hours, is known sometimes to induce toler- 
ance; so that no emesis whatever is had from it. This does not 
apply, however, to the changes made from habit, but is brought 
on by the sedative effect of large doses, impairing sensibility for 
the time. If given daily in moderately emetic portions, no such 
tolerant influence will be exerted, but, on the contrary, the sus- 
ceptibility will probably be increased. 

Arsenic and opium are agents with which the effect of habit, 
in their use, has been thoroughly tested. Immense quantities of 
these are taken with impunity by persons in the habit of using 
them regularly. In this country, the former is rarely, if. ever, 
used in this way, nor the latter, to the extent it is in Asia and 
other parts of the world. The sad reality, however, of the 
destructive habits of "opium eating" and "whisky drinking," 
are witnessed, alas! too frequently in America!! 

Habits of life have such controlling influence over the physical 
conformation of man, that much depends upon them for the 
natural condition of parts to be acted on, and consequently for 
the ordinary physiological action of remedies. 

6. Temperament. — This, in the main, is an inherited style of 
physical conformation, but may be modified to some extent In- 
habits of life, climate, etc. Be this as it may, there is no doubt 
that temperament should be taken into the account in order 



CLASSIFICATION OF REMEDIES 55 

definitely to calculate the degree of physiological action to be 
effected by certain medicinal agents, and the therapeutic changes 
obtained from them. In lymphatic subjects, antiphlogistic meas- 
ures are borne badly, while in the bilious and sanguine, depletion 
to any desirable extent may be resorted to without inconvenience. 
When the nervous influences predominate, exciting neurotics must 
be used with caution, lest excitement beyond the normal standard 
be suddenly induced. So with other forms of natural constitution. 
Those organs whose strength and influence predominate, bear 
up better under depressing influences; and to the extent the nat- 
ural energies of the system are concentrated in them, will other 
organs be found deficient in physical and functional powers. 

In order to pursue the study of therapeutics advantageously, 
these physiological subjects must be first understood. 

The usual operations of organs in a healthy condition, and 
the variations, from causes above recited, not amounting to dis- 
ease or deformity, should be well studied. 

Works on physiology give full information on these points, 
and should be carefully read by the student of therapeutics. 

The quantity of medicines must necessarily be modified by the 
various circumstances enumerated, but by none so much as age. 

Dose for Children. The dose mentioned in connection with 
the description of remedies must always be understood as the 
proper quantity for adults, unless otherwise stated; and in order 
to arrive at the proportion for a given age under eighteen, 
various rules have been suggested. Perhaps the most convenient, 
and one sufficiently accurate, is the following by Dr. Young: 

Take the age of the child for the numerator, the age added to 
12 for the denominator, and the fraction thus formed will indi- 
cate the proportion of an adult dose for the particular case. 

Thus: 2+12=14, 2-14=1-7, the fractional part of the adult 
dose, proper for a child of two years old. ( U. S. D.) 

CLASIFICATION OF REMEDIES. 

The paramount objects of scientific writers and teachers are 
to facilitate the learner in the acquisition of knowledge, and to 
insure its lasting impression upon the mind. They are more 
effectually accomplished by the correct manner in which subjects 



iCQLOGl 

arc arranged and presented i«>r study. Groups made of those 

similar in certain respects may be learned with almost as much 
ease as one taken separately. A proper classification of remedies 
Is particularly useful to the student of Acology and Therapeutics. 
Remedies are studied only with the prime object of making 
practical use of them, and, in order to this, their arrangement 
for study must be made with reference to their medicinal prop- 
erties. On actions, not botanical or sensible peculiarities, Bhould 
classification be based. Classification founded on botanical origin, 
chemical similarity or physical resemblance would not, therefore, 
meet the requirements of the learner. In the most important, 
and yet difficult item of study, no advantage could he derived 
from such arrangement, Worse still is that empirical system of 
grouping together articles according to imagined ulterior results 
in the specific cure of particular diseases, without regard to their 
physiological action. Nothing so completely blights the pros- 
pects of ambitions students, and turns the rising genius from 
the path of rational medicine, than the tempting fallacy of ther- 
apeutic classification, Were it true that every disease had its 
specific, never-failing remedy, irrespective of surrounding cir- 
cumstances, then should we dispense with the toil of physio- 
logical and pathological research, and seek perfection in the 
healing art, by the knowledge of a true specific for each disease 
to which mortals are subject. Then, truly, could the weary 
practitioner cease his tiresome watchfulness over pathological 
changes taking place during the progress of disease. But such 
blessing has not been our lot, nor have we even a prospective 
hope ol its realization. All good, all safety, that can come of 
medicine must flow through philosophic, rational investigation. 
Extensive works on Materia Medica, embracing articles about 
which little is known, further than their sensible properties, can 
not well be arranged to carry out the system of classification 
best adapted to the practical study of remedies. General divi- 
sions, such as vegetable, mineral and mechanical agencies, with 
an alphabetical order for the individual articles, are all that can 
be made, including the large number of articles treated of under 
such an arrangement. Until the effects of a remedy are prop- 



CLASSIFICATION OF REMEDIES. 57 

erly known, it cannot with propriety bo included in a classifica- 
tion based on the action produced in the system. 

Pereira's world-renowned Materia. Medica, and the United 
States Dispensatory are of this description. Although the forms 
of classes are given with very many useful suggestions on the 
subject, yet, in the general description of agents, no such system 
is observed, for the reason, just given, that a large number of 
articles would necessarily be left out of it, for the want of relia- 
ble accounts of them, sufficient to fix upon their action and 
proper classification. Such works are essential to the preserva- 
tion of the facts that are known concerning all remedies individ- 
ually, and for this purpose are best arranged for reference in 
alphabetical order. 

In books, however, intended to present the student of thera- 
peutics with facilities for learning readily the means of combat- 
ting disease, those articles only are important whose medicinal 
properties have been thoroughly established. Such remedies are 
subject to systematic classification, based on the known physio- 
logical properties they possess; and in such arrangements facility 
is afforded the learner to acquire a knowledge of them. 

Simplicity and system are necessary to a useful classification. 
Eberle, Pereira and Wood take nominally the physiological action 
of remedies for the basis of their arrangement, but from their 
tables the learner cannot obtain a clear idea of a complete system. 
In fact, such is not claimed for them by the authors. There is 
not in any of them that strict adherence to the principle upon 
which they are intended to be founded, which is necessary to 
make a systematic arrangement. Prof. Wood, than whom no 
writer in America has done more to promote the advancement of 
rational medicine, adopts a somewhat complicated system, and 
admits its imperfection, in certain respects. The difficulty exists 
in failing to observe strictly a physiological basis of classification, 
a rule by which his system is partially governed. If physiological 
action is to govern the classification in one instance, it must do so 
in all. The ultimate or therapeutic results should not control, in 
the least, the arrangement and names of classes. In his plan, 
neurotics arc set down as remedies having general action, thereby 
.basing their classification on the therapeutic results manifested 



ECOLOGY. 

in various portions of the body. Emetics and cathartics arc 
recognized by bis classification as local remedies, when in truth 
each of them affects the whole animal economy, as does opium, 
by its elective action upon a particular organ. Ipecac or gam- 
boge, in its therapeutic results may, and generally does indirectly 
affect the whole system. 

As one of the learned authors, above referred to, has remarked 
many of our valuable remedies are not sufficiently understood, 
in their modus operandi to he properly classed. While this is 
true, and while, as above stated, what is known of them should 
be preserved in suitable works for this purpose, there is a sufficient 
number of them whose effects are known, to furnish complete 
classes tor systematic text books. Such collation is essential to 
students commencing therapeutic investigations. 

In the arrangement we have adopted, harmony, in many par- 
ticulars, with the systems referred to, will be discovered. To 
these authors, particularly the great American Pharmacologist, 
Dr. Geo. B. Wood, the director of our studies in early life, are 
we indebted for much that will be fbuud in the pages of this 
work; not only concerning the properties of remedies and their 
arrangement into classes, but for views connected with their 
modus operandi and application in the treatment of disease. 

To carry out strictly a system of physiological classification, 
new names must necessarily take the place of those by which 
classes of remedies are generally known. This innovation i s 
pardonable only as the means of consistency in arrangement 
and great practical benefit to the student. The acknowledged 
definition of physiological action must be kept in view, viz. 
that which is invariably had by a remedy upon an organ, 
whether diseased or healthy. Blennymenal stimulants, enteric 
excitants, cerebral stimulants, etc., etc., denote direct physiolo- 
gical action, and should take the place of names such as "expec- 
torants," "cathartics," "anodynes," etc., which indicate the 
functional modification that may occur from their action, under 
a proper state of circumstances. Therefore, certain remedies 
whose action is exerted directly upon the mucous membranes 
generally, upon the brain, bowels or other parts, should be asso- 
ciated under the name indicating this influence, without regard 



CLASSIFICATION OF REMEDIES. 59 

to the result of such upon the function of the organ acted on. 
These and other excitants of particular organs may promote 
their functions when below the ordinary state of excitement. 
No remedy will invariably increase the function of an organ, 
but any of them will always, when they act at all, have the 
• same physiological action of stimulation, depression or tone. 
When, therefore, it is desirable to restore a function that has 
been disturbed by abnormal excitement of the organ, remedies 
having a sedative effect upon it are selected ; but when the fail- 
ure depends upon depression, excitants will be more likely to 
restore it. It may be set down, then, as an established tact, that 
remedies of opposite action may promote the function of an 
organ in different states, and that all remedies which act elect- 
ively through vital process excite, depress or give tone to the 
organs upon which they act, or for which they have affinity. 

When the excitement is of temporary character, the remedy 
is called a stimulant ; when permanent, the term tonic is applied. 
The impression is had without regard to the condition of the 
organ at the time, but the result of the action upon the function 
often depends upon the degree and character of disease which 
may then exist. If hepatic excitement already exists to 
the extent of inducing that state called inflammation, and the 
function is, in consequence, so far disturbed as to arrest the secre- 
tion of bile, it is not likely that additional excitement by a hep- 
atic stimulant will lead to favorable change in the function; and 
even when of ordinary vigor, mercury and other excitants may 
lessen the secretion by over-excitement. If, however, the liver 
be below the ordinary standard of excitement, and the function 
is deranged in consequence, restoration of the secretion may be 
expected from the stimulant. The same remedy, therefore, may 
prove cholagogue or anti-cholagogue, according to the condition 
of the organ leading to the deranged function. Hence, the term 
cholagogue applied to a class of remedies necessarily leads to 
erroneous conclusions and unfortunate practical results. 

The enlightened medical mind no longer tolerates the idea of 
specific mysterious curatives. No one can now, with safety to his 
reputation as a rational physician, content himself short of a 
knowledge of the modus operandi of remedies. In order to this, 



60 aCOLOGT. 

the student of medicine should not be taught by the use of terms 
which lead to routine practice. u Alteratives," "diaphoretics," 
"antispasmodics," etc., are terms applied to classes of* remedies, 
which, though they express the occasional and uncertain func- 
tional changes or results following the actions of certain remedies, 
lead the learner to rely upon that in which he is doomed to vexa- 
tious disappointment. Diluents of the blood, excitants of the 
brain, general refrigerants, cardiac sedatives, etc., may lead to 
cutaneous transpiration, under the proper state of circumstances. 
The same may be said of remedies acting exactly the opposite of 
those mentioned. So that if a class of diaphoretics be recognized, 
the catalogue should rightfully include every means used in the 
arrest of inflammatory and febrile affections. The error now 
entertained by some that diaphoretics finally produce copious 
perspiration, and thereby "cool the fever," is similar to that of 
practitioners half a century ago, in regard to the alteraticc effects 
of mercury in the treatment of malarial fever. The theory of 
that day, upon which was founded the extensive use of mercury 
in the treatment of remittent fever, was, that the production of 
ptyalism cured the disease, when in truth the fever from self 
limitation abates before salivation is likely to occur. Many an 
unfortunate victim of the salivating and sweating theories can 
bear testimony of their evil consequences. 

Alteratives, known as the mysterious curatives of various chronic 
diseases, and general debility of unknown pathological origin, are 
each given with the uncertainty of " bread cast upon the waters," 
which may or may not "be gathered many days hence." This 
mysterious class is made up of remedies, now known to act as 
catalytics of various morbific and natural ingredients in the blood, 
such as syphilitic and scrofulous matter, fibrin, etc. The name 
catalytic, which indicates the action had, seems preferable. 

Writers agree on the importance of physiological classification, 
but all alike doubt the possibility of making it systematically. 
The interests of the profession and the public weal, in the educa- 
tion of medical students, demand an effort. If in the attempt, 
the author fails to impress the profession with the propriety of his 
course, he will not tail, at least, to excite thought and arouse a la- 
tent feeling of interest in the fundamental principles of rational, 



PHYSIOLOGICAL CLASSIFICATION. 



61 



practical medicine. Empirical devotees to one-ideal systems find 
much of comfort and encouragement in their course, from the 
therapeutic classifications and specific curatives of the adherents 
of rational scientific medicine, and the learner should be taught, 
early in his course of study, to shun the breakers of empiricism. 

PHYSIOLOGICAL CLASSIFICATION. 



( 1 R 

f 1 Remedies that af- | „ y 

feet the Skin 



1 Local action thro' 
Vital Process. 



2 Local action thro' 
Chemical Process. 

3 Local action thro' 
Mechanical Pro- 



Rub efaci en ts. 
« ** Vesicants. 
(3 Pustulants. 



2 Remedies that af- 
fect all Soft Tissues 

1 Remedies that af- 
fect Adventitious 
Substances and 
Structures. 

1 Remedies that af- 
fect internal and 
external Surfaces 



1 Astringents. 

2 Catheretics. 

3 Aromatic Excitants. 

J 1 Anthelmintics. 
j 2 Escharotics. 
j 3 Antiseptics. 

1 Demulcents. 

2 Emolients. 

3 Mechanical Counter Irritants. 



f 1 Hsematinics. 

f 1 Elective Action j 1 Remedies that J, , 
«j . .1 t>i 1 3 Diluents, 
affect the Blood. } . „ . *• 

4 Haemostatics. 



through Chemi- 
cal Process. 



[' 1 Remedies that af- 
fect the Alimen- 
tary Canal. 



2 Remedies that 
feet the Heart 



af- f 



[ 5 Catalytics. 

1 Inverse Gastric Excitants. 

2 Enteric Excitants. 

3 Gastric Tonics. 

1 Cardiac Stimulants. 

2 Cardiac Sedatives' 

3 Cardiac Tonics. 



3 Remedies that af- 
fect the Mucous 
Membranes. 



2 Elective Action j 4 Remedies that af- 
through Vital j feet the Nervous 



I Pr. 



System. 



1 Blennymenal Stimulants. 

f 1 Cerebral Stimulants. 

j 2 Cerebral Sedatives. 

3 Cerebral Tonics. 

4 Excito-motor Stimulants. 

5 Excito-motor Sedatives. 

6 Spinal Stimulants. 
I 7 Spinal Sedatives. 

[ 8 Spinal Tonics. 



(1 Haspatico-Salivary Stimulants 
5 Remedies that af- | 2 Hsepatic Tonics, 
feet the Secer--] 3 Renal Stimulants. 
nent System. | 4 Renal Sedatives. 

[ 5 Renal Tonics. 



6 Remedies that af- 



f 1 Genital Stimulants. 
j 2 Genital Sedatives, 
tect tne JTocrea ^ g Tj ter i n e Stimulants. 
I tive Organs. [4 Uterine Sedatives. 



62 ACOLOGY 

While fertile foregoing arrangement perfection is not claimed, 
vet Itv it the student is enabled to take a concise view of a clas- 
sification founded on the physiological action of* remedies. 

Only two genera] orders are recognized in the plan adopted; 

one including those medicines having elective tendency toward 
certain organs, when taken into the blood; the other, those purely 
local, affecting only the parts to which they are topically applied. 

Of these, three sub-orders are made and named, in accordance 
with the vital, chemical or mechanical process through which 
action is produced. 

Each sub-order includes all the remedies which have their 
effect through one or another of these processes respectively. 

Each division is made up of remedies which act upon a par- 
ticular organ or system of organs; and the name given to each 
class, distinctly shows upon what particular part the action of 
remedies included in it, is exerted, and the character of that 
action, whether exciting, depressing, tonic or soothing. 

Thus, in the division of "remedies that affect the nervous sys- 
tem/' are included all agents treated of in the work, impressing 
any one of this system of organs; and the class "cerebral stimu- 
lants/' for example, includes the articles which excite the brain 
to increased energy. 



ORDER I. 

LOCAL REMEDIES. 



SUB-ORDER I. 

THROUGH VITAL PROCESS 



DIVISION L 

REMEDIES THAT AFFECT THE SKIN 



CLASS I. 

RUBEFACIENTS 



The name of this class denotes the kind of action produced. 
Usually a -prefix to the name indicates the part acted on, but 
to this, such is unnecessary, since the reddening produced by 
these remedies is universally understood to be on the external 
surface. The term rubefacient — from rubefacio, to make red — 
may be applied to any means having this effect, whether acting 
through vital, mechanical or chemical process, but those only 
which act through the former can be properly considered under 
this, our first sub-order. 

The physiological effects of this class are rarely, if ever, exerted 
upon the part diseased, and such articles are generally, therefore, 
indirect therapeutic agents. 

The objects of their use are, counter- irritation and revulsion. 
By the first, an existing inflammation, irritation or pain is 
relieved, through the establishment of excitement in a contiguous 
sound part; the irritation thus artificially made giving increase 



r»i L0OLOG1 

of blood in the surface on the principle, thai "where there is 
irritation there is a flow," and to thai extent counteracts existing 
internal derangement. In this way the pain and excitement in- 
ternally are temporarily abated by the new irritation of a rube- 
facient on the surface. 

By revulsion is meant that general modification of the circu- 
lation in which the head, for example, is relieved from supera- 
bundance of blood by rubefacient measures applied to the lower 
extremities. Thus the circulation is equalized, the peripheral 
vessels being made to carry more blood, while distant parts are 
relieved to that amount from engorgement. 

These are the most speedy and transitory of the counter-irri- 
tants. Their effects are not sufficiently powerful nor lasting to 
be exclusively relied on in violent local disease or serious circu- 
latory disturbance; but their promptness makes them important 
preliminaries and auxiliaries to more effective means. 

Catalogue of Rubefacients. 

Sinapis. Olea Aromaticus. 

Oleum Terebinthinse. Aqua Ammoniac. 

Capsicum. Chloroform urn. 

Chloral. .Ether. 

Sinapis — Mustard. 

The seeds of Sinapis alba and Sinapis niger, well known 
herbaceous plants, cultivated extensively in Europe and America 
for the seeds. Their color gives name to the species of the plant 
from which they are derived. 

Mustard is a valuable rubefacient, and is used also as a condi- 
ment, for its exciting effects upon the stomach. Pulverized 
sinapis, for its local application to the skin, is mixed with water 
or vinegar, and used in the form of cataplasm, called sinapism. 
This is made by spreading the mixture, of semi-fluid consistence, 
on cloth or paper, of suitable dimensions for the particular case, 
and applied to the skin over the affected part. Thirty minutes 
are required usually to redden the surface sufficiently. 



AND THERAPEUTICS. 65 

The mustard may bo placed directly in contact with the skin, 
or included in a fold of well moistened old linen, and allowed to 
communicate its properties through the meshes. By being mixed 
with syrup, a more adhesive cataplasm may be made, which, 
though sufficiently effective, requires more time for its action. 
The burning sensation is sometimes exceedingly painful, when 
the mustard is mixed with water or vinegar and applied directly 
to the skin, and on this account may be advantageously prepared 
in this way. It is not only painful in its action, but sometimes, 
when applied to young subjects or delicate females, and suffered 
to remain too long, may produce vesication, which sometimes 
leads to unnecessary and painful sores. 

A sinapism is found useful- in various forms of local disturb- 
ance. For the treatment of malarial fever, in order to insure the 
arrest of an expected paroxysm, by quinine, or such other ner- 
vous tonic as may be used, mustard applied over the spinal 
column is often salutary. It should be used when the antiperi- 
odic is administered, so that the engorgement and irritation of 
the spinal cord, which sometimes exist, may be relieved at the 
time the tonic eifect is being produced. Failure to arrest an 
approaching paroxysm is often met with, from neglect in affording 
timely counter-irritation over the spine. In that state of the 
cord causing reflex nervous manifestations, such as hysteria, etc., 
counter-irritants are indispensable to prompt relief; and mustard 
generally answers well for this purpose. 

Charta Sinapis — Mustard Paper. This preparation is made 
by mixing mustard with a solution of gutta percha in chloro- 
form, to a syrupy consistence. It is a very convenient mode of 
using the remedy, and may be prepared for application by dip- 
ping in warm water, for a few seconds, a piece of such dimensions 
as may be required, placing it at once upon the surface. 

Oleum Terebinthixje — Oil of Turpentine. 

This is the distilled oil of the oleo-resin or juice which exudes 
from the wood of Pinus pedustris and other species of Pinus and 
Abies. The former are stately trees, found abundantly in South- 
5 



66 ACOLOGY 

ern portions of the I nited States. The oil found in commerce 
is distilled from the turpentine of the species of Pinus princi- 
pally, but turpentines and balsams from the Abies afford an 
equally pure and useful oil. 

Oil of turpentine is a transparent, colorless, thin liquid, and, 
owing to the process by which it is obtained from turpentine, and 
the want of oily appearance, it is called Spirit of Turpentmie. It 
will be again referred to in the classes of " cardiac stimulants" 
and "blennymenkl stimulants." 

When placed on the skin in a way to prevent its evaporation, 
or with friction, turpentine acts as an effective rubefacient. The 
effect is also temporary, but less painful than that of mustard. 
The skin may be reddened in a tew minutes by friction with 
the fingers dipped' in the oil, or by the application of a pledget 
of lint or fold of linen saturated with it. In children, the skin 
over the larynx and tonsils may be reddened in this way without 
excessive pain, when affected with croup and tonsilitis; and the 
effect may be kept up any desired length of time. So with the 
spine, chest or abdomen, when a temporary counter-irritant is 
desirable for internal disease of these parts. It is also found a 
useful ingredient in anodyne and rubefacient liniments, intended 
for the spine and the surface along the course of painful nerves. 

Capsicum — ( hyenne Peppt a ■. 

The fruit of Capsicum anum, an annual herbaceous plant, cul- 
tivated extensively in Europe and America. This well-known 
fruit is in variously-shaped pods, according to the different vari- 
eties of the plant from which they are derived. Like most 
vegetables and animals, the pepper plant, as well as the charac- 
ter of its fruit, is changed by climate and the various circum- 
stances connected with the plaee of its growth. 

Pepper is gathered, when ripe, dried in the shade, pulverized 
and preserved in well-stopped bottles. The taste is excessively 
pungent, and it excites a burning sensation in the mouth and 
throat when swallowed. 

Cayenne, or red pepper, as it is sometimes ealled, is a local 



AND THERAPEUTICS. 67 

stimulant of considerable powers, and acts well as a rubefacient 
when applied to the skin. 

Pulverized capsicum may be prepared in the form of cata- 
plasm, as directed for mustard, and used for the same purposes. 
The pain from it is perhaps less severe, while its eifects are more 
permanent, leaving the skin, sometimes, in an inflamed condi- 
tion for several days, yet without vesication. A pediluvium, 
made with infusion of pepper, or a mixture of mustard and 
pepper with water, is supposed to effect important revulsive 
action in congestion of the brain and other vital organs. 

There are many other means of reddening the skin, some of 
which will occasionally be found more convenient than those 
already mentioned. It is not deemed necessary, however, to 
give them a prominent position and separate description in this 
class. One of these, friction, will be noticed under the head of 
"mechanical counter-irritants," in the sub-order of remedies act- 
ing through mechanical process. 

Chloral, a recent addition to the catalogue of remedies, and 
described under the head of " cerebral sedatives," has been highly 
recommended as a rubefacient by a neighboring physician, whose 
experiments with it, in this way, proved highly satisfactory. A 
kind of sedative or anodyne influence was thought to result from 
its application, allaying pain and nervous irritability of internal 
organs more effectually than by ordinary counter-irritation. 
More experience in its use, however, is necessary to confirm this 
opinion. For local application chloral is moistened with water, 
rubbed into the form of paste and smeared upon the surface. 

The Essential Oils of cinnamon, peppermint, doves, etc., when 
rubbed upon the skin, act promptly as rubefacients, equally effi- 
cient with mustard, and without more pain than results from the 
action of this popular counter-irritant. 

Ammonia, Chloroform and Ether act as rubefacients, and 
will vesicate when applied to the skin if continued sufficiently 
long and protected from evaporation. A piece of cloth, corre- 
sponding in size with the part to be impressed, saturated with 
any of these liquids, placed upon the surface and covered with a 
folded napkin, affords the means of reddening the skin promptly. 



68 IC0L0G1 

With ammonia, particularly, a short time only is required to 
produce this effect; and if continued for twenty minutes, will 
cause vesication. It' suffered to evaporate freely, however, these 
substances produce refrigoration instead of redness and excitement. 

CLASS II. 

VESICANTS. 

Irritants of a peculiar kind, and more powerful than rube- 
facients, causing a separation of the cuticle from the true skin 
and an effusion beneath the former, produce what is known as a 
blister or reside. 

Their mode of operation in counteracting internal disease is 
similar in some respects to rubefacients. The most important 
differences being the degree of action and its permanence. 
Blisters also produce a kind of local depletion, not obtained from 
less powerful counter-irritants, and which is sometimes important 
in the treatment of inflammation. Vesicants, then, may be said 
to allay internal irritation, engorgement and inflammation by 
counter-irritation, depletion and re nils ion. The first of these 
modes is not limited, in its benefits, to the modification produced 
in the circulation. By any degree of irritation upon the skin, 
whether only to the extent of rubescence, or to full vesication, a 
state of irritation is set up, which counteracts a like condition in 
an adjacent diseased part. This state of the nerves -in an irrita- 
ble or inflamed tissue is a fruitful source of pain, and tends 
greatly to. aggravate existing inflammation. Indeed, it is not 
unlikely that in this way the timely use of counter-irritants may 
prevent its establishment, by allaying nervous irritability. 

The general rule applicable to the use of this class, is, that in 
excessive permanent irritation, acute or chronic inflammation 
or congestion of internal organs, blisters are beneficial. 

The part selected for the application is that immediately over 
the affected organ, or as nearly so as practicable 1 , when counter- 
irritation is sought. If, however, revulsion be the object in view, 
the blister should be applied to parts remote from that in which 
the engorgement exists; as, in fullness of the brain or abdominal 
and thoracic viscera, the wrists and ankles are the points selected. 



AND THERAPEUTICS. 69 

Inflammation in certain organs seems to be more under the 
influence of blisters than that of some others, equally near the 
surface. Disease of the eerous and mucous membranes connected 
with the respiratory organs appears to be more controllable by the 
remedy than when located in the parenchyma of the lungs. 
Hence, it is prescribed with more confidence in pleuritis and 
bronchitis than in pneumonia. 

Blisters are indispensable in enteric affections, particularly that 
of obstinate colo-rectitis or dysentery, when general remedies fail 
to alleviate the paroxysms of pain and frequent discharges. 
Under these circumstances a blister, applied to the hypogastrum 
gives efficiency to anodynes, astringents and other internal 
remedies. 

As an auxiliary to quinine in the treatment of rheumatism, a 
blister to the spine is sometimes indispensable Cases of acute 
articular rheumatism are met with, which, at the onset of the 
disease, yield readily to these agencies combined, after having 
resisted quinine alone; and, as in intermittent fever, all cases are, 
perhaps, more certainly relieved by associating counter-irritants' 
of this kind with other treatment. 

The practice of treating rheumatism by a succession of blisters 
to different parts of the body, indiscriminately, has been recom- 
mended ; but the reports of cases thus treated, do not give suffi- 
cient evidence of certainty and promptness of reliefj to warrant 
the use of such painful treatment. Indeed, the fact that severe 
attacks sometimes recover as soon without blistering in this way, 
leads to doubts of its efficacy. 

The extent of surface that should be blistered safely is an im- 
portant point to be considered in the use of this valuable 
remedial means. As a general rule, it may be proper to state 
that the blister should be commensurate with the extent of dis- 
eased surface within, when used for the counter-irritant effect. 
Circumstances, however, may make a variation from this rule 
necessary. Something more than the mere extent of internal 
disease must be considered in deciding upon trie amount of coun- 
teracting influence to be used. The degree of irritation and in- 
flammatory excitement must also enter into the account. It has, 



70 



\^■i)\^H)\ 



therefore, been proposed, as the better rale, thai the amount of 
irritation produced by the Mister should exceed thai existing in 

the diseased organ. Even this may lead to -rave error when 
carried to an unwarrantable extent. The blister itself, when ex- 
cessively large, may prove a source of nervous and vascular dis- 
turbance sufficient to prostrate the vital energies. Doubtless 

children and delicate adults, with irritable state of the nervous 
system, are sometimes subjected to injury from this cause, less 
controllable than the disease itself. 

Catalogue of Vesicants. 

Cantharis. 
Aqua Ammonise. 
Caloric. 



Cantharis — Cantha rides. 

The dried insect or beetle, cantharis vesicatorm. This fly 
abounds in Spain, and hence the common name, Spanish 
flies. The insect is a little less than an inch long, one-fourth 
of an inch broad, and of a beautiful greenish color, particularly 

Fig 1. 




Cantharides. 



the legs and wings. They have an unpleasant penetrating odor, 
and acrid disagreeable taste. The principle upon which their 
vesicant property depends is called eantharidin. 

Ceratum (\ndhandk— Cerate of Cantharides.. This, like 
other cerates, is composed of wax and lard, in proportions to insure 
adhesion to the surface without heat or moisture, in which is 
thoroughly mixed the pulverized Hies. It is spread upon cloth, 



AND THERAPEUTICS. 71 

paper or leather when required For use, or kept in the shops in 
largesheets so as to be cut into the proper size and shape required. 

Spanish Hies afford the only vesicant in very general use; 
being certain and efficient for this purpose. Occasionally, how- 
ever, vesication is demanded more speedily than it can be had 
from this substance, and other means, to be noticed hereafter, are 
brought into requisition. 

From four to eight hours are required to produce full vesica- 
tion by cantharides in this form. Unpleasant effects sometimes 
follow its use from the absorption and elective action of cantharidin 
upon the kidneys and bladder, and the most distressing strangury 
is, in some persons, occasionally produced. It is said that this 
tendency may be, in a great measure, counteracted by previously 
bathing well the part to which the blister is applied, with tinc- 
ture of camphor. If security be thus afforded against this 
troublesome difficulty in the use of cantharides as a blister, the 
manner in which protection is given has not been ascertained, 
positively, but probably by arresting the usual amount of 
absorption. 

Several other preparations of cantharides are used for the 
purpose of blistering. 

Charta Epispastica — Blistering Paper, sometimes called Blis- 
tering Tissue — is used for this purpose, and made by spreading on 
paper a mixture of cantharidin and wax. This is said to be less 
liable to produce strangury than the cerate, and less active as a 
vesicant. It is, therefore, preferable for children and sensitive 
females, in whom the skin is more susceptible to vesicant action. 

Collodium Cum Cantharide Cantharidal — Collodion — is a mixture 
of the etherial tincture of eantharides with collodion, and is spread 
upon the part intended for the blister with a brush or camel's 
hair pencil. The ether evaporates rapidly and leaves cantharidin, 
the active principle of flies, with the gun-cotton firmly attached 
to the skin. The process may be repeated, if necessary, till the 
requisite amount of cantharidin is in contact with the surface to 
produce full vesication. 

This is, perhaps, still less active than the blistering paper, but 
is free from the inconvenience of compress and bandage, required 
for the other preparations mentioned. 



72 ACJOtOGl 

Acetum Cantharidis — Vinegar of Gantharides — is an officinal 

preparation of flies intended for vesication. The solution of 
cantharidin, the active principle of the drug, in acetic acid re- 
quires a temperature nearly up to the boiling point of water, and 
it' digestion at about the temperature of 200' Fahr. is not had, 
the strength will not be sufficient to insure the full activity of 
the remedy. 

A blister may be formed speedily by applying it with a brush 
repeatedly for several minutes. It is said that one or two hours 
will be sufficient to produce the full effects with the vinegar of 
cantharides, while the ordinary cerate requires five or six hours 
to effect this object. 

Other means are sometimes resorted to with the view of pro- 
ducing- vesication more speedily than it can be effected with the 
preparations of cantharides. 

Am mould, mentioned under the head of rubefacients, will 
vesicate when applied to the skin, if evaporation be prevented. 
A cloth, the size required for the blister, may be saturated with 
this liquid, applied to the surface and covered by a compress so 
as to retain it in contact with the surface. When required only 
of small size, a watch-glass placed over the part to which the 
ammonia is applied, will effectually prevent evaporation and 
secure the vesicant action in a very few minutes. Cases occur, 
in which it is important that counter-irritation, such as is pro- 
duced by blistering, be had without delay; and under such cir- 
cumstances, this article may be found useful. 

Caloric may be used as a powerful counter-irritant; and 
although it acts by a kind of chemical process, and is not, there- 
fore, appropriately considered in connection with remedies having 
vital action, yet practically it is, perhaps, better that it be alluded 
to in this connection. 

The Actual Cautery is highly esteemed by some, when the 
emergency is such as to require immediate vesication. By this 
means powerful counter-irritation is speedily produced, but cases 
are rarely met with in which remedies less alarming and painful 
will not prove equal! effectualy. It is true that iron heated to a de- 
gree which will produce complete destruction of the tissues, may 



AND THERAPEUTICS. 73 

be rapidly passed over the skin in a manner to induce vesication 
only, and with less pain than when of lower temperature, but 
will always prove a source of terror to patient and friends. 

Hot Wafer may be used for this purpose, and though speedy 
and effectual, is liable to the objections urged against the hot iron. 
It may be applied by a towel saturated with the hot water, and 
requires but a moment to effect the object intended. The ex- 
tremities or any portion of the body can be promptly blistered 
in this way, if such application should be demanded. 

CLASS III. 

PUSTULAXTS. 

Certain substances affect the skin, when placed upon it, by 
slow process, so as to form, pustules. To the class now under 
consideration belong such articles; and their action, though not 
so powerful as that of blisters, is more permanent, and gives less 
annoyance to the patient. 

They are, of course, applicable to chronic diseases only, in 
which long continued counter-irritation is demanded. Several 
days are required to establish pustules, but they may be perpet- 
uated for any desired length of time, and without much pain to 
the patient, by renewing the application as they begin to disappear. 

Chronic disease of the liver, lungs, stomach, spine, kidneys and 
uterus often require permanent counter-irritation of this kind. 

It is not alone to the irritation produced by this class, that all 
their benefits are due, for the constant drain established by them 
serves as a kind of revulsive and depleting measure, highly useful 
in relieving chronic engorgement and inflammation. 

Catalogue of Pustulaxts. 

Unguentum Antimonii. 
Oleum Tiglii. 

Ungeunttjm Antimonii — Aatimcmial Ointment. 

The double salt, tartrate of antimony and potassium, forming 
the active ingredient of this ointment, has a prominent place in 



7 1 ACOLOCfl 

the classes of "inverse gastric excitants " or emetics and "cardiac 
sedatives/' in a subsequent pari of this work where a more accu- 
rate description will be found. Its local action, when given 
internally is thai of an irritant, and, as will be seen, it must l>e 
given with caution on this account. 

The ointment is made by mixing two or three drachms of 
tartarized antimony with an ounce of lard; and may he used by 
rubbing a small portion on the skin three times a day until pus- 
tules appear, which may be expected in two or three days. These 
run their course in less than a week, usually, and in order to keep 
up the impression a renewal of the application should be made 
as the pustules decline. Sometimes, though rarely, furunculous 
collections of pus take place from the pustulation, giving uneasi- 
ness to the patient, and require to be evacuated by the lancet. 

Tartarized antimony, though an irritant to the internal and 
external surfaces of the body, has a peculiar action upon the 
skin, and makes its impression slowdy. When used in this way, 
it is not absorbed in sufficient quantity to produce its elective 
effects upon the stomach ; as nausea, which results from its intro- 
duetion into the rectum and other parts, in which absorption 
occurs, is never produced by its application to the external surface. 

The use of this ointment on the epigastrum in chronic gastritis, 
or the chest in pulmonary disease, causes pustular eruption 
which may be continued for weeks or even months without seri- 
ous inconvenience to the patient, and with great advantage in the 
treatment of these effections. 

Unpleasant nervous symptoms from reflex nervous impressions 
and from actual disease of the spinal cord, may be allayed by a 
crop of pustles along the spinal column, during the direct treat- 
ment of uterine or other organic disease, upon which such nervous 
perturbation depends. 

Oleum Tiglii — Croton Oil. 

The expressed oil from the seeds of Croton Tigliwm. This is 
an excessive irritant, with whichever of the soft structures it may 
come in contact. Hence, it acts as a powerful irritant cathartic; 
and under this head is more minutely described. 



AND THERAPEUTICS. 75 

When croton oil is rubbed upon the skin, at intervals of six or 
eight hours, a pustular eruption makes its appearance in a day or 
two, with more or less general inflammatory excitement of the 
surface. The pustules require several days to run their course, 
during which considerable irritation is kept up, resulting in the 
discharge of small quantities of pus. 

It compares favorably with tartar emetic, as i counter-irritant, 
and is,- perhaps, preferable in most cases, owing to the promptness 
of its action and the freedom from unpleasant furunculous 
swellings. 

Being a violent drastic cathartic in small quantity, the natural 
impression is that, when applied to the skin, absorption, to the 
extent of producing catharsis, should occur. Such, however, 
does not seem to be the case; and the failure to do so may be ac- 
counted for in a knowledge of the fact that an irritant to the 
surface may interfere with absorption from the part, and also by 
the supposition that its action as a cathartic is not elective, but 
local. 

The oil is usually applied in full strength, but when used 
upon delicate subjects may be diluted with olive or some other 
bland oil. Such mixture, doubtless, constitutes the German 
nostrum used in connection with acupuncturation by an instru- 
ment called lebens weaker — life-waker. 

Numerous small pustules result from the application of croton 
oil, and, as they disappear, may be renewed by reapplication of 
the oil. 



DIVISION II. 

REMEDIES THAT AFFECT ALL THE SOFT TISSUES. 

This division is also made up of classes containing local 
remedies. It is, however, true that articles in some of them are 
also found under the head of elective remedies, which are taken 
into the circulation in order to their action. The class of astrin- 
gents, for instance, contains several remedies which also have 



7(5 AC0L0O1 

prominent places amongst "cerebral tonics" and "haemostatics." 
Their astringent tonic and styptic effects, however, differ widely 
from each Other. That action upon the solid structures by which 
they arc const ringed — made firm and compact — is called astrin- 
gency, and the impression made on the blood by them, rendering 
it more coagulable, is termed styptic or haemostatic. Acetate of 
lead may be usefully applied to relaxed or inflamed parts, and 
hence belongs properly to a division of local agents under the 
head of astringents; and the same article is administered so as to 
enter the circulation in order to its action npon the blood itself, 
as other elective remedies, included in the class of haemostatics. 

CLASS I. 

ASTRINGENTS. 

The name of this class — from ad, to, and stringo, to bind — is 
intended, as nearly as possible, to describe the aetion of the arti- 
cles it contains. They eonstringe or contract, condense and make 
firm any of the soft tissues to which they are applied; thereby 
lessening the amount of capillary circulation and the tendency 
to effusion of blood or other fluid through the surface thus affected 
by them. By this impression, superficial inflammation or relax- 
ation of the surface, with which they are in contact, may be re- 
lieved. A large number of vegetable and mineral substances 
are included in the class, affording every degree of action from 
a slight roughness to the most powerful constringency. The 
more active articles, which destroy tender and fungous granula- 
tions, and answer the purpose of mild cauterants, constitute, 
when diluted, a considerable proportion of the most useful astrin- 
gents. These may be denominated Gathereties, and will occupy 
a separate class under this name. 

The milder variety, which will be considered under the head 
of astringents alone, are useful internally as well as for external 
application, in order to produce contraction and condensation of 
the surfaces. Diarrhoea, from relaxation, or inflammation of 
the mucous membrane lining the bowels, may often be controlled 
by the internal use of mild astringents. The existence of acute 



AND THERAPEUTICS. 77 

inflammation and general febrile excitement, are not, as has been 
supposed, circumstances which contra indicate their use, but their 
action above described will, evidently, tend to correct this abnor- 
mal state. 

In a class comprising so many articles it is not necessary that 
all of them be described in a work oi this kind. If is only 
important to name some of each variety, so that every peculiarity 
of action may be represented. 

Catalogue of Astringents. 

Plumbi Acetas, Rubus, 

Geranium, Kino, 

Quercus, Krameria, 

Galla, Catechu, 

Acidum Tannicum, Hasmatoxylon, 
Acidum Gallicum. 

Plumbi Acetas — Acetate of Lead. 

This is a heavy crystaline salt, of sweetish astringent taste, and 
soluble in water. All the preparations of lead produce poisonous 
effects if given in excessive dose, or continued too long in moder- 
ate quantity. 

Sugar of lead is considered one of the best mild astringents, 
as a local application for the relief of inflammation in delicate 
structures. As a collyrium in conjunctivitis, a solution of two 
or three grains to the fluidounce of sassafras or elm mucilage, it 
is used with much benefit. A perfect solution is necessary, however, 
when applied to delicate and sensitive tissues, in order to avoid 
the irritation likely to occur from undissolved particles of car- 
bonate of lead which may remain in the solution. The addition 
of a few drops of vinegar, or subjecting it to filtration will, 
perhaps, prevent this difficulty, by removing the irritating cause. 

In chronic disease, when the action of an astringent is required 
for a considerable length of time, lead is not an appropriate 
remedy, and should not be used, lest the quantity absorbed may 
induce the poisonous effects upon the nervous system, A singular 



78 ACOLOGY 



paralysis of the upper extremeties is said to result from the long 
(•out i lined use of very small quantities, introduced into the stomach, 
or other parts, from which absorption readily takes place. Two 
or three grains to the fluidounce of water make the proper 
strength .for internal or external use. The dose of this is, from 
a half to <( fluidounce, when taken into the stomach. 

Alumen — Alum. 

This, aeeording to the Pharmacopeia 1 revision of 1870, is 
sulphate of aluminum and ammonium. It is in the form of 
white octohedral crystals, slightly efflorescent, soluble in water, 
and of sweetish .astringent taste. 

Alum is powerfully astringent, and employed externally in 
diseased conditions for which very decided astringent action is 
required, and as a wash in affections of the throat, vagina, 
urethra, etc. An ounce to the pint of water makes a solution of 
proper strength for these purposes; but should vary according to 
the organ affected, and the nature of the disease for which it is 
used. 

Alum, administered internally for the ordinary astringent 
effect, in disease of the stomach or bowels, must be limited in 
amount to the dose which will not affect the peristaltic contraction 
of the canal. A drachm of the salt is necessary to the emetic 
effect, while ten or fifteen grains are sufficient to impress any part 
with its astringency. 

It has been employed for its styptic effect on parts which can 
be reached only by absorption into the circulation, but is, doubt- 
less, inferior to acetate of lead for this purpose, particularly as a 
haemostatic, in uterine hemorrhage and hematuria. 

Many other mineral astringents may be mentioned. Sulphate 
and chloride of zinc, sulphate of copper, nitrate of silver, sulphate 
cadmium and chloride of iron are highly astringent, and when 
properly diluted, answer the purposes for which other articles of 
the class are used. They are capable of effecting more powerful 
action, however, and it is thought proper to consider them only 
in the class of catheretics. 



AND THERAPEUTICS. 79 

A large Dumber of vegetable substances have astringent prop- 
erties, with which it is unnecessary to encumber a work of this 
kind, intended more for the establishment of a system of practieal 
study, than for thoroughness as a book of reference. In a 
class having so large a number of substances, it is only necessary 
for this purpose, as above stated, that representative articles of 
each peculiarity of action should be mentioned. This is not 
intended as a record of botanical facts connected with medicinal 
plants, nor a Dispensatory in which the history, preparations and 
dose of every medicinal agent can be found. 

The number of astringents are so large that it would require 
an unreasonable space, to do more than mention the most impor- 
tant articles, and give the peculiarities they possess. These are 
principally used in relaxation, and other diseased conditions of 
the alimentary mucous membrane, leading to diarrhoeal and dys- 
enteric symptoms. 

Geranium — Cranesbill. 

The root of Geranium Maculatum or Spotted Cranesbill, an 
indigenous herbaceous plant with perennial root, found abund- 
antly in the rich alluvial soil of low, moist situations. This 
root, though imparting to the mouth the roughness of ordinary 
astringents, is comparatively free from the unpleasant bitter taste 
of most other vegetables of the class, and on this account is more 
readily taken, and more acceptable to the stomach, than most 
astringents. It is a convenient remedy for the treatment of 
bowel affections in children, and for this purpose is sometimes 
boiled with milk, constituting a preparation that affords, at the 
same time, nourishment and astringency; by which the tendency 
to diarrhoea and relaxation may be counteracted, and general in- 
vigoration afforded. 

A decoction, made by boiling an ounce of the root in a pint 
and a-half of water down to a pint, may be used in the dose of 
two fluidounces every three or four hours. 

Two extensive families of indigenous plants belong to the class 
of astringents, and afford all that is absolutely necessary for the 
full action of vegetable astringents, viz,: Quercus and Bubus. 



80 ICOLOGl 

Besides these, we have not only many other indigenous astringents, 
but a long list of foreign origin, to say nothing of the numerous 

mineral preparations having this property. 



Quebcus Al.HA — WhiU Oak. 

The hark of Quercus alba, an indigenous tree attaining im- 
mense size, and found abundantly on fertile soil in low situations 
throughout the Southern States. This is a useful astringent, 
being readily obtained, effective as an astringent and not unpleas- 
ant to the taste. 

Decoct um Querelas AlUe — Decoction of White Oak — is the only 
officinal preparation of this bark, and may be given with benefit 
when astringents are necessary, in the dose of two fluidounces. 

Quercus Tinctoria — Black Oak. 

This is the inner bark of Quercus tinctoria, an indigenous tree, 
which, in many portions of the country, constitutes almost the 
entire forest growth. 

There are various other species of oak, but these are the most 
important, and the only two recognized by the United States 
Pharmacopoeia. 

Querents Infectoria is the name given to that species from which 
the nutgall is obtained. 

Galla — Gall* — are the result of injury to the branches of 
this species of the oak by an insect that pierces the bark. 
From this an excrescence or tuber arises, which forms the (jail, or 
nutgall. 

An Infusion of the various species of oak and of the nutgall 
is a preparation by which their astringent action may be obtained. 
This is made by pouring a pint of boiling water on an ounce of 
the contused bark, or coarsely powdered galls. 

Tu:o or three fluidounces of the infusion may be taken three 
times a day, or more frequently, if required, in bowel affec- 
tions, etc. 

For internal use, the infusion, made from the bark of Quercus 
alba, is preferable to that of other species of the oak, on account 



AND THERAPEUTICS. 
Fig. 2. 



81 




Qitercits Infectoria. 



a. Branches with male flowers. 
c. A male catkin. 



b. Branch with female flowers. 
d. Nut (acorn), and capsule. 



of its mildness and less disagreeable taste. The virtues of these 
productions of the oak depend upon two crystalizable principles, 
viz.: 

Acidtjm Tannicum and Acidum Gallicum — Tannin, or Tan- 
nic Acid, and Gallic Acid. 

The latter is produced by a kind of fermenting process in tan- 
nin, so that gallic acid is made at the expense of tannic acid. 
These active principles are soluble in water, and answer all the 
purposes for which the oak can be used. Tannin may be given 
in the dose of five grams, while gallic acid is required in double 
this quantity. 

Rubus — Blackberry. 

The root of Rubus Canadensis, R. Villosus, R. Trivialis, and, 
perhaps, various other species of rubus. It is supposed that not 
6 



82 



\< OLOGY 



less than twenty of these indigenous species have been discovered. 
The "blackberry" "dewfjerry" and "raspberry" are the familiar 
name- of those mentioned above, and constitute the most prominent 
species of the plant. The roots of all these have rough astrin- 
gent taste, and yield their virtues to water. 

A decoction, made by an ounce of the bruised root, to a pint 
and a hull' of water, boiled down to a pint, contains the activity 
of the remedy, and may be given in thecfo.se of three fluidov/nces. 

There is no very important difference in the medicinal proper- 
ties of these indigenous plants, so far as their astringency is con- 
cerned, and any special application made of a particular plant 
has been suggested by convenience, or other circumstances con- 
nected with the patient's comfort. 

Kino. 

The inspissated juice, from incisions made in the bark of 
Pterocarpits Marmpium, an inhabitant of Africa. 




Pterocarjrm Mar^njn u/» . 



Several varieties of kino are found in commerce, derived from 
different sources, the main features of which do not differ mate- 
rially from each other. 



ANT) THERAPEUTICS. 83 

Kino is in small angular masses of dark brown color, bitter 
astringent taste, easily pulverized, and partially soluble in water. 
It is an efficient astringent, and may be given in substance in the 
dose of ten or fifteen grains. 

An Infusion is made by pouring a pint of hot water upon half 
an ounce of kino. Of this, one or two fluidounces may betaken. 

It has been highly recommended in menorrhagia, and for 
this purpose should be repeated every two or three hours, till an 
impression is made. As a styptic, for this purpose, it is, per- 
haps, inferior to other haemostatics. 

Tinctura Kino — Tincture of Kino- -is an officinal preparation 
and will be found a convenient and reliable astringent for bowel 
affections, in the dose of two fiutdraehms. 

Objection has been made to this and other tinctures on account 
of the alcohol they contain, but the doses above mentioned is 
not likely to prove injurious in this way. 

K rameei a — Eh atany. 

The root of Krarneria Triandria, a shrub found in South 
America. 

Rhatany is somewhat tonic and powerfully astringent. It is 
suited to the treatment of acute or chronic enteritis, relaxation, 
etc., manifested by diarrhceal discharges. 

The Infusion and Decoction are convenient preparations, but 
the quantity to be taken may sometimes interfere with its ad- 
ministration, particularly when irritation of the stomach exists* 
Of these, two or three fluidounces may be given for the astrin- 
gent effects of the remedy, and repeated according to circum- 
stances. 

Solid Extract and Tincture of Rhatany are less bulky and in- 
convenient. These can be readily given for any desirable length 
of time in the treatment of bowel affections, combined with solid 
or liquid preparations of other remedies; the former, in the dose 
of fifteen grains; the latter, two fluidrachms. 

Catechu. 

Extract from the wood of Acacia Catechu, a small tree found 
in both Indies, and for some time unknown, generally, as the 



84 LCOLOG 

source of commercial catechu. Ii is perpared from a decoction 
of the wood, evaporating partly by artificial heat, and then by 
exposure to the air until of solid consistence. 

The choice of these vegetable astringents is merely a matter of 
preference from familiarity or habit in their use. There is, per- 
haps, no article amongst those we have mentioned which might 
not, with propriety, be substituted for any other; and yet this i.^ 
a favorite astringent with many practitioners. Catechu in sub- 
stance may be given in the dose of ten grains. 

The Tincture is in very common use, and will produce full as- 
tringent effects in the dose of two fluidrqehms. While, as above 
stated, there is no good reason for preferring this to other vege- 
table astringents, at the same time there is, perhaps, more exten- 
sive use made of it by some, than most other astringent remedies. 

1 1 . E M ATO X YX.0 N — Log WOOt I 

The wood of Heematoasyfon ( hmpe<ichianum } a tall trw, growing 
in various portions of Central America. The wood, which is a 
considerable item of commerce in these tropical countries, is used 
extensively as a dye. 

Logwood is esteemed a valuable astringent, possessing active 
properties, unconnected with irritating qualities. It is, therefore, 
advised in the treatment of bowel affections, to which the more 
irritating articles may prove injurious; and in acute inflamm. tion 
of the mucous surface of the intestines in children it is peculiarly 
suited. 

Infusion and Decoction are suitable extemporaneous pre- 
parations, unless the quantity required be more than proves 
acceptable to the stomach. The dose is two fluidounces, repeated 
according to the circumstances of any particular case. This, for 
the reason just given, is, perhaps, more appropriate in enteric 
acute inflammation than more irritating articles. 

Solid Extract of Logwood answers well for administration in 
solid form. Dose, ten grains. When given with other solid 
substances, the extract is, of course, preferable to liquid prepara- 
tions of the remedy, and may be given in the form of pill or 
powder. 



AM) THERAPEUTICS. 85 

CLASS II. 

C A T H E II E T I G S . 

Tins class is made up chiefly of articles usually found in the 
catalogues of astringents and cauterants. 

Catheretie action — from fcadaepsa), to remove — is that by 
which ulceration, with unhealthy granulations, is changed by 
the destruction and removal of these abnormal attempts at resto- 
ration of the tissue. Chronic inflammation is also counteracted 
by the astringent influence upon the blood vessesl of the part, 
and destructive action upon unhealthy granulations, and semi- 
organized fibrin. 

This effect seems to be a combination of cauterant and astrin- 
gent properties, and is one of the most important of all known 
local actions. It is by this that the ulcer is changed in the char- 
acter of its surface, and the amount of pus discharged. The 
powerfully constringing influence which strangulates the fungous, 
unhealthy granulations also prevents fibrous deposit and the con- 
sequent purulent accumulation. Very powerful astringents 
become cauterants to all tender and very vascular tissues, while 
ordinary healthy and firm structures are not at all affected by 
them. Such are called catheretics. 

The term local altertive has been applied to this kind of action. 
The name "altertive" has also been given to a class of elective 
or general remedies, whose action, at the time, was not very well 
understood, and which, of course, should not be retained since 
the true modus operandi of the class has been determined. 
"Catalytic," therefore, now takes its place, and "catheretie," we 
think, is properly substituted for "local alterative." 

A destructive cauterant or escharotic may, by dilution, become, 
a catheretie. Of such are the mineral acids. These, when ap- 
plied to sound parts, destroy their vitality, but by being properly 
diluted may be used as catheretics. 

Particular structures require milder action than others, and the 
degree or character of disease, in a part, must govern the practi- 
tioner in the selection of agents for the proper degree of action. 
It is not always the case, however, that acute requires milder 
catheretics than chronic inflammation. 



80 AOoLOGt 

In acute diseases of the throat and air-passages, very active 
preparations answer well to abort the commencing inflammation 
by a kind of strangulation, the powerfully constringing influence 
Leaving no excitement or irritation. In this way, according to 
the experience of some practitioners, membranous croup is sud- 
denly arrested by the introduction of a strong solution of arg. 
nit. into the larynx. Acute tonsilitis is allayed, some times, in 
the same manner. 

As has been stated, astringents, so far as their styptic influence 
is concerned, produce their effects after absorption and intro- 
duction into the circulation. In this ease, however, the blood 
itself is acted on by the remedy. The effects of lead in hasina- 
turia, menorrhagia, etc., are instances of this kind. Catheretic 
action, however, cannot be had upon a part, if the article be 
taken into the circulation, in order to reach it; the solution being 
too weak when thrown into the mass of circulating fluid. In 
the present state of improvement, the modes of introducing rem- 
edies allow the direct application of catheretics to all the mucous 
membranes, except that connected with the ureters and kidneys. 

Catalogue of Catheretics. 

Iodinum, Argenti Nitras, 

Acidum Carbolicum, Zinci Chloridum, 

Zinci Sulphas, Cupri Sulphas, 

Cadmii Sulphas, Iodoformum. 

Iodix um — Iodine. 

This remedy is described in the class of catalvtics, its prepara- 
tions being more generally useful and important, as such, 
than any other agent belonging to that class. In some affections, 
for which iodine is used electively, in this way, it also proves 
highly beneficial as a local catheretic. Both these qualities may 
be made useful in scrofula, syphilis and phthisis; all of which 
diseases lead to local results requiring the direct application of 
catheretic remedies, and iodine answers well for this purpose. 
By the catalytic effect it causes elimination of the virus, pabulum, 



AND THERAPEUTICS. 87 

or germ of degenerate substances which constitute the diseases in 
question. To this we shall hereafter allude when on the prepa- 
rations of iodine as a catalytic. 

Fames of Iodine, of all the substances which have catheretic 
action, is more readily applied to the respiratory organs. Under 
the old plan of vapor inhalation, this substance, in the form of 
tincture, was, perhaps, more certainly carried into the lungs than 
many other remedies used in this way, owing to the volatile 
nature of the iodine itself. The more recent and useful practice 
of using, by inhalation, remedies in concentrated form, however, 
has led to the substitution of the fumes for more dilute prepara- 
tions, by which the iodine, in substance, finds ready transmission 
to the minute bronchi and air cells. For this purpose atomizers 
and inhaling apparatus are entirely unnecessary. A vial, two or 
three inches deep, with large mouth, answers every purpose. 
Into this let two or three scales of iodine be placed, and a candle 
or lamp held under it. When the violet colored fumes begin to 
fill the vial, it should be applied to one nostril, the other being 
closed by pressing one of the alse with the finger, while a sudden 
forcible inspiration carries the fumes to the pharynx in a direction 
favoring their ready entrance into the larynx and bronchia. 
The nostrils should be made to alternate so that the irritation of 
its passage may be divided between the two. In this way, 
without expensive apparatus, or the consumption of more time and 
quantity of the remedy than would be necessary for administra- 
tion by the stomach, the whole respiratory tube, including the 
nares, may have iodine in full strength brought in contact with 
its surface. 

The inhalation through the mouth, answers for the tonsils, 
fauces, epiglottis, uvula, and even the bronchia; but the direction 
of the fumes, when they reach the glottis, being nearly at right 
angles with the larygial canal, is somewhat unfavorable for their 
ready entrance. 

Iodine may be used in this way for chronic bronchitis, from 
ordinary causes, or as the result of tuberculous deposit. In the 
latter, the combined catalytic and catheretic effects may, to some 
extent, follow its inhalation. Even acute bronchitis, and that 



IC0L0G1 

irritable condition of the tubes leading to asthmatic spasm, may 
be allayed in this way. Ordinary catarrh, effecting the nasal 
canal-, fauces, etc., may be benefited by such inhalation. 

For chronic affections of the respiratory organs, the inhalation 
.should be repeated at intervals of one or two days. Chronic 
catarrh or bronchitis is more certainly controled by this than any 
other plan of treatment. t 

Tiiictura Iodinii — Tincture of Iodine and ZnigoVs Solution of 
Iodine, made by dissolving in an ounce of water forty grains 
iodide potassium and twenty grains of iodine, in the form of 
Spray bu the atomizer, may by successfully applied to the fauces? 
interior of the larynx, etc. An apparatus, by which the fauces 
are kept constantly filled with the spray of the liquid applied, is 
in use for this purpose. By it the larynx and trachea may he 
impressed with liquid preparations of iodine. Thus, chronic in- 
flammation of the epiglottis, rima glottidis, or any part of the 
vocal apparatus, may be successfully treated by this mode of ap- 
plication. 

In cuticular erysipelas the application of iodine, in any con- 
venient fluid form, is sometimes exclusively relied on. The 
routinish manner in which the local use of iodine in erysipelas 
was made during the late war was impressed by a laughable mis- 
take that occurred with a sick soldier in William and Mary Col- 
lege Hospital, Virginia. At the surgeon's round the number of 
a certain bunk was named on the prescription book as having an 
occupant with erysipelas of the left ear. Before the prescriptions 
were ready he changed beds with another soldier, and at the 
round next morning it was ascertained that the man with ery- 
sipelas had nothing done for him the previous night, while he 
with whom the change had been made, exhibited the ridiculous 
appearance of a sound ear thoroughly reddened with iodine. 

Tnis remedy is used to excite, in cerous and other tissues, a 
kind of adhesive granulation, by which parts brought in contact 
are made to unite 1 . Dilute liquid preparations are injected into 
cysts, in order to cause adhesion of their sides and consequent 
obliteration. Also, in hydrocele, the water being evacuated, the 
tunica vaginalis is injected with the view of permanent cure. 



AND 1'MKKAPEUTICS. 89 

By the late improvements in the treatment of uterine diseases 
these forms of preparation are in very general use. It is now 
believed that in most eases of chronic womb affections endo- 
metritis exists, and that applications to the interior mucous mem- 
brane are necessary to permanent relief. For this purpose Lu- 
gol's aqueous solution, or the tincture, mixed with an equal por- 
tion of glycerine, is used in various ways. Some practitioners 
prefer the mode of introducing, on the point of a probe, a pledget 
of cotton or lint saturated with one of these liquids, so as to bring 
it in contact with the whole interior of the cavity. 

Others prefer injection into the cavity by a graduated syringe, 
manufactured for the purpose. The latter mode is doubtless 
more effectual, but has been discarded by many on account of the 
unpleasant symptoms which sometimes result from the introduc- 
tion in this way. 

Spasm of the womb, called uterine colic, will frequently result 
from the sudden and forcible injection into its cavity of even a 
small quantity of any liquid, giving rise to violent pains; and, 
when under such circumstances, a drachm or two is contained in 
the cavity, it is thought that fatal effects may be produced by its 
being forced through the fallopian tubes into the cavity of the 
peritoneum. 

In order to guard against these difficulties, it is necessary to 
proceed cautiously in the operation. Fifteen or twenty drops of 
the watery solution of iodine can be safely injected into the 
womb, by passing the nozzle of the syringe to the fundus, and, 
in withdrawing it, stop at regular points and press the piston 
very gently so as to discharge, slowly, three or four drops at each 
point throughout the cavity. Since adopting this plan, I have 
seen but one case of uterine colic, and it subsided in ten minutes. 
It probably occurred from carelessness in suddenly throwing into 
an irritable uterus, too much iodine at one point. The same 
ease was treated afterwards, until the /aire was effected, without 
difficulty. 

The proper interval to be observed in making this application 
to the uterus is all important to success in the treatment. Three 
or four days is sufficiently long, and more than a week should not 



90 ACOLOG1 

be allowed to Intervene, unless it becomes necessary to defer the 
treatment on account of menstruation or other caug 

Aia.KMi Nitras — Nitrate of Silver. 

'The crystal ine form of this salt is more suitable for internal 

use, and will be mentioned under the head of cerebral tonics. 

An/cnfi Nitras Fusa — Fused Nitrate of Silver — Lunar ('(rus- 
tic is the form generally used for local application as a cat he- 
retic, particularly if required in the concentrated strength 
of the solid stick. To obtain this, the crystals are fused 
in a porcelain dish and poured into cylindrical moulds of silver. 
The stick affords a convenient form for the application of the 
solid nitrate, when a powerful local action is desirable, and may, 
also, be dissolved and used in any required strength. The crys- 
taline salt is, however, preferred, when used for any purpose in 
the form of solution. 

For the treatment of external diseases by catheretic action, 
Lunar caustic is deservedly the most popular article of the class; 
and is equally applicable to internal organs that can be reached 
by ordinary solid or liquid preparations. The alimentary mucous 
membrane, the uretha, bladder, vagina and interior of the uterus, 
are parts to which it may be applied in any desired strength of 
solution, and to most of them in the solid state, if necessary. 
Perhaps the mucous membrane of the alimentary canal is acted 
upon with less certainty than any of the parts mentioned, owing 
to the liability to absorption before the remedy reaches the part 
affected. The stomach and rectum may be mentioned as excep- 
tions to this general fact. A solution may be thrown into these 
parts of the canal and before the salt can be absorbed, will make 
its local impression on the mucous membrane. 

As a general rule, in the administration of this remedy, for its 
local effect upon the canal, the preparation should be varied to 
suit the part diseased. If the stomach is to be impressed, the 
liquid form allows the remedy to come in contact with the dis- 
eased surface at once. Pills are preferable for impressing the 
small intestines, particularly when incorporated with ingre- 



AND THERAPEUTICS. 9 1 

dients not readily softened by moisture. They may be so made 
as to pass through the canal without being entirely dissolved, 
and in this way the loeal eatheretie action may be had upon the 
mucous surface throughout its entire extent. 

Although given internally for this action upon the prima? viae, 
the effect sought is as purely local as when applied to an ulcer 
upon the external surface; and its absorption interferes with, 
instead of promoting, this effect. 

In gonorrhoea! and other chronic forms of ophthalmia, the 
nitrate of silver makes an appropriate eatheretie. For these 
affections of the conjunctiva, tarsi and cornea, the solid stick is 
very often used. Caution is necessary, however, in its applica- 
tion, lest destructive action upon the cornea may result from its 
earless use in certain conditions of this tunic. 

The abortive treatment of gonorrhoea by injections of concen- 
trated solution of lunar caustic, at one time popular, is now rarely 
attempted; for a strong solution applied indiscriminately to the 
whole uretha, often results in injury to the mucous membrane, 
and sometimes in stricture. Coming in contact with the inflamed 
portion only, or used in weak solution, there is no doubt that 
much advantage is derived from the remedy in this disease, and 
its judicious use should not, therefore, be discarded. Chronic 
inflammation of the bladder, partieularly at its neck, giving almost 
constant trouble from strangury, is most successfully treated by 
the direct application of a moderately strong solution, say ten 
grains to the ounce of water, carried to the point of disease, 
through a catheter, so as to come in contact with the diseased 
surface, without affecting other parts. 

Externally, to all manner of ulcers, chancres, unhealthy 
wounds, etc., lunar caustic is occasionally useful, and is often 
applied in the solid stick. 

Acute or chronic inflammation of the tonsils and larynx is 
sometimes promptly relieved by the direct application of a solu- 
tion of the nitrate; and this may be made by a probang and 
sponge, but, perhaps, more readily and effectually by the spray 
from an atomizer. 

The ulcers which are sometimes, though rarely, found on the 
os uteri, may be healed by a few very slight touches of the solid 



02 ACOLOG1 

nitrate, or a solution applied with a sponge or uterine syringe. 
This, and the persistent inflammatory symptoms connected with 
the os and eervix, are hut the out-croppings of general and or- 
ganic derangement, and to prove permanently successful, other 

additional treatment must he used in order to impress the whole 
organ. As the result of neglected primary congestion or en- 
gorgement of the uterus, more or less permanent ehronie inflam- 
mation, ulceration and enlargement of the uterus are found to 
exist. That which might have been prevented bya Little timely 
local depletion is found to have resulted in chronic endo-metritis, 
with all the general nervous and local evidences of what has been 
known as irritable uterus. 

Constant discharge of transparent mucus, as seen on the os 
tinea), proves the existence of chronic inflammation within the 
organ. Under these circumstances, general depletion is injurious, 
while neurotics, counter-irritants and local depletion are only 
palliative and auxiliary. Nothing short of catheretic action 
upon the intra-uterine mucous membrane, gives any certainty of 
permanent relief. 

Different substances and different modes of application are 
proposed and recommended. As the nitrate of silver has been 
more extensively used in the various lesions of the uterus, their 
mode of treatment in detail is considered in connection with this 
article. 

The introduction of solid nitrate of silver, or any other solid 
catheretic to affect the uterine mucous membrane, is rarely at- 
tempted, except to that of the cervix, on account of the difficulty 
in making proper application, which, however, it is believed, 
may ere long be overcome. Pulverized nitrate of silver, impacted 
in a groove at the end of a small silver probe, is now sometimes 
applied to the interior. This may be passed over the mucous 
surface of the neck and body, and carried, though with difficulty, 
even into the fallopian tubes, without danger of uterine colic or 
other serious detriment, further than severe pain and soreness. 
A solution of this salt, in various degrees of strength, is introduced 
by different modes, into the uterine cavity. A suitably shaped 
sponge tied on a probang and saturated with the solution, may be 



AND THERAPEUTICS. 93 

parsed into the womb, and made to come in contact with its 
mucous surface. This, however, is also a difficult and uncertain 
operation. In some cases the probang cannot be made to enter; 
and even when introduced, the solution is measurably pressed 
from the sponge before passing through the cervix. Notwith- 
standing, much benefit is sometimes received from this operation, 
by its impression upon the mouth and neck. The sponge used 
in this way may be saturated with liquid preparations of iodine 
for the same purpose, and with similar results. 

A popular practice in such cases is the introduction, on the 
point of a probe, lint or cotton saturated w T ith a solution of this 
salt as mentioned for the use of iodine in this affection. 

For chronic endo-metritis, perhaps, no better article can be 
used than nitrate of. silver, provided the application be properly 
made. The solution forms with mucous a firm mass, however, 
and when a portion is applied to the surface covered with this 
tenaceous fluid it is prevented from contact with the diseased mu- 
cous membrane, and requires additional application. 

For this reason the nitrate of silver is not always preferable to 
iodine, since it is considered unsafe to inject any considerable 
quantity of a liquid into the uterine cavity, either at once or at 
different injections in quick succession. 

\Vith Butler's hard-rubber, graduated uterine syringe, and the 
exercise of proper caution, there is no doubt that this remedy 
may be used so as to give prompt relief. A solution of ten to 
thirty grains to the ounce, used as directed for the injection of 
iodine, in the preceding article, may be repeated in five or ten 
minutes, and thus insure its impression upon the diseased surface. 
It gives less pain than iodine, but is equally liable to produce 
uterine colic, when carelessly used. 

Acidum Carbolic :oi — Carbolic Acid. 

This is a peculiar substance obtained from coal-tar or petroleum, 
and almost identical with creasote obtained from w 7 ood-tar. 

Carbolic acid is congealed in its preparation and remains in 
the solid form, if secluded from the atmosphere, and kept at a 
temperature below 7 65° Fahr. In appearance, peculiar odor and 



94 ECOLOGY 

pungent taste, it resembles creasote almost exactly. Not only 
arc the sensible properties of these two substances similar, but 

their medicinal virtues seem to be almost the same, notwith- 
standing: that »»ne is of mineral and the other of vegetable origin. 

Carbolic acid is used by the stomach not only for it- local 
catheretic action in passing over a diseased surface of the canal, 
but as a styptic and antiseptic, locally or alter absorption into 
the circulation. 

The action of this substance upon the tissues is different from 
that of ordinary astringents, and, yet, the results arc similar. 
Contraction and condensation are the effects of the acid, and 
very much the same are expected of active astringents ; but while 
the former produces this condition by a peculiar exciting influ- 
ence, the latter do so by ordinary astringency. Carbolic acid is 
said to be particularly applicable to injuries and local diseases in 
which there is excessive suppuration, on account of the peculiar 
property of arresting this process, which it possesses, independ- 
ently of that for which it may be used as a catheretic in most 
cases where iodine and nitrate of silver are applicable. 

The solution of carbolic acid in glycerine affords a valuable 
catheretic injection for chronic endo-metritis, vaginitis and sim- 
ilarly diseased mucous membranes of other organs. Nitrate of 
silver in glycerine is used for the same purpose, and sometimes 
both are dissolved in this fluid together for the various local ap- 
plications made of each separately. The unctuous consistence 
of the solvent, renders the preparation soothing and protecting 
to denuded and irritable parts, for whose relief the catheretic in- 
gredient is applied. 

Zrxci Chloridum — Chloride of Zinc. 

This is a deliquescent substance of waxy consistence, strong 
chlorine odor, and acrid, burning taste. In the concentrated or 
undiluted state, it forms an active cauterant and eseharotic, and 
may lead to injurious and even destructive action upon sound 
parts. As a catheretic, therefore, it is never used in the concen- 
trated state, but, being soluble in water, one or two grains to the 
fluidounce will make a preparation of proper strength for ordinary 



AND THERAPEUTICS. 95 

catheretic effect. It has been successfully used as an injection in 
gonorrhoea, and accounts are given of its having proved successful 
in some eases which had resisted the usual treatment. It is also 
useful as a local application in indolent, ill-conditioned ulcers, 
from its antiseptic, as well as catheretic property. 

The strength may be varied according to the amount of effect 
required, and when diluted to suit the ease treated, it possesses 
advantages even above nitrate of silver in some respects. The 
mildest catheretic and the most active cauterant may be made 
by the different degrees of dilution to which it is subject. 

Zinci Sulphas — Sulphate of Zinc. 

Under the head of cerebral tonics, this salt has a prominent 
place and is more minutely described. It may be used for ordi- 
nary astringent or mild catheretic effect, in chronic inflammation 
of delicate tissues, in which its action is particularly desirable. 
Chronic tarsal opthalmia, sometimes tedious and annoying, is 
generally very promptly relieved by the daily application of sul- 
phate of zinc in the strength of four grains to the fluidounce of 
water. Like all other local applications to sensitive, delicate 
structures, it should be freed from irritating undissolved par- 
ticles, by filtering through paper or cloth, before being used as a 
collyrium. 

Cupri Sulphas — Sulphate of Copper. 

This cerebral tonic, noticed as such under the appropriate 
head, is also an effective and useful catheretic. Applied in the 
solid state to newly formed granulations, it has a very decided 
cauterant effect, and is used for the destruction of fungous and 
other unnecessary granulations, particularly a form of chronic 
conjunctivitis called granular ophthalmia, for which the solid salt 
is sometimes used. 

Blue stone may be reduced to any desirable strength by solu- 
tion in water, or by mixing with lard in the form of ointment. 
In chronic diseases of the scalp, it is a useful remedy when made 
into some convenient form for application in the particular case 
under treatment. 

Certain preparations of iron may be used as catheretics, and 



96 ICOLOGl 

will be noticed more particularly as styptics. These are, Persuf- 
fkaJU cud Perclorick of Iron. The catheretic action depends 
iij)oii their powerful astringency. They may, therefore, by proper 
dilution, be made to serve the purpose of mild astringents. This 

is true also of most other catheretics, as before stated. 

Cadmii Sulphas — Sulphate of Cadmium. 

r lnis salt, in its sensible and medicinal properties, very much 
resembles sulphate of zinc, and has been used for similar purposes 

as a local application. Indeed, its elective effects, by which im- 
pressions are made on the digestive organs and nervous system, 
are supposed to be similar to those of white vitriol. Preference 
is, however, given to cadmium as a collyrium in the treatment of 
chronic or acute conjunctivitis. 

A solution in the mucilage of sassafras madulla, of one to four 
grains to the fluidounce, is doubtless one of the most useful reme- 
dies in ordinary ophthalmia. The mucilage should be made with 
distilled water, and, after solution of the salt, should be filtered 
or strained, in order to free it from any undissolved substance 
that would necessarily tend to irritate the sensitive conjunctiva. 
The proportion of cadmium should be regulated to suit the stage 
of disease in the eye, and applied only at proper intervals, so as 
to prevent the increase of irritation from too frequent use. 

It is altogether probable that a proper test of its use as a cathe- 
retic in chronic inflammation in other parts, may prove entirely 
satisfactory, and that cadmium is not inferior to local remedies 
more extensively applied. 

Ioboformu m — Iodoform. 

Chemically, this is the teriodide of for my 1, found in the form 
of small yellow crystals, of sweetish taste, insoluble in water, but 
soluble in alcohol and ether. It is volatile, but not corrosive. 
As a local anaesthetic, anodyne or local alterative or catheretic, it 
has been used as an application to uterine cancer, in the form of 
ointment or paste, made by the addition of a scruple of iodoform 
to an ounce of cocoa butter. By it relief is given from the tor- 
turing pain, so common in this distressing affection. (Reporter.) 



AND THERAPEUTICS. 97 

In the form just mentioned, there is no doubt that highly im- 
portant cut heretic or local alterative effect is produced upon 
ordinary chronic inflammation and ulceration, particularly when 
arising from syphilitic and scrofulous contamination. The sooth- 
ing influence exerted upon the part, makes it peculiarly suited to 
irritable and ill-conditioned ulcers from any cause. 

It has been used in the dose of three or four grains as a cata- 
lytic or general alterative in the treatment of goiter and scrofula, 
but the ordinary preparations of iodine are, perhaps, preferable. 
As a general anaesthetic it has been used, but being less effective 
than chloroform and ether, cannot be made to take the place of 
these remedies. 

As a catheretic to irritable parts affected by ulceration or 
chronic inflammation, this remedy will, perhaps, be found most 
useful. While the surface is impressed in a manner to change 
the persistent local disturbance, its anaesthetic property affords 
relief from suffering. 

CLASS III. 

AROMATIC LOCAL EXCITANTS. 

These remedies, when introduced into the stomach, bear the 
same relation to gastric or digestive tonics, which diffusible 
nervous stimulants do to nervous tonics. Aromatics give imme- 
diate, but temporary excitement to the stomach, the skin and 
other soft parts to which they are applied. The stomach and 
bowels are stimulated to vigorous action by their administration ; 
so that indigestion, or spasmodic contraction of any portion of 
the canal, from inactivity, is controlled. No soft tissue is exempt 
from the exciting effects of the aromatic essential oils, but they 
are used for their action upon the skin and mucous membrane of 
the alimentary canal only, and will not be found in any class, 
except this, of general loeal excitants, t applicable particularly to 
inactivity of the stomach, and that of rubefacients. 

All articles of this class have a strong agreeable odor, pun- 
gent, pleasant taste; and their action upon the digestive organs 
seems to be that of local stimulation to the mucous membrane of 
7 



98 AC0L0G1 

the canal, which is extended to the muscular coat. Then, not 
only are the folicles ami glands excited to an increased secretion 
of the Quids, necessary to perfeel digestion, but, by this stimulus, 
the essentia] peristaltic movement of the stomach and bowels is 

also promoted. 

Were these effects permanent, the local stimulation of aromatics 
would afford all that i.^ necessary to relieve debility of the diges- 
tive apparatus, so far as the process of chimification is concerned 

but they are not; and in order to keep up the energy thus in- 
duced, the remedy must be repeated at each period of taking 
food, until the effects of agents having more permanent action 
can be had. To this end, combinations are made of aromatic 
substances witlr gastric tonics, so that digestion may be promoted 
at once by the former, while the latter, which require several 
days to make their impression, may be slowly working more 
permanent effect. 

In nausea, without undue heat of the stomach, aromatics are 
serviceable; and, owing to their pleasant taste, will be found not 
only acceptable to the stomach, but useful to conceal the taste and 
prevent the griping effects of certain remedies upon the bowels. 
In the use of certain cathartics their addition is essential to the 
patient's comfort. Senna, when uncombined with some aromatic, 
usually produces severe griping, and is often associated in this 
way when prepared for use. 

Catalogue of Ajromatic Local Excitants. 

Cinnamomum, Fceniculum, 

Zingiber, Pimenta, 

Caryophyllus, Piper, 

Mentha Piperita, Myristica, 

Mentha Viridis, Aurautii Cortex, 

Calamus, Vanilla, 

Cascarilla, Canella, 

Lavandula, Coriandrum, 

Anisum, Cardamomum, 



AND THERAPEUTICS. 
Onnamomum — Cinnamon. 



99 



The bark of Omnamomum Zeylanicum and Cinnamomum Aro- 
maticum. 

The former is a native of Ceylon, and transferred to various 
other tropical islands; the latter is found in China, whence the 
bark is exported. 

Cinnamon bark, prepared for the market by stripping it from 
the branches, removing the epidermis and drying, forms rolls or 

Fig. 5. 




Cinnamomum Zeylanicum. 



quills, as found in commerce. It has an agreeable odor, pungent, 
pleasant taste; and, when pulverized, which is readily effected 
a mixture may be made with tonics, cathartics or other medicinal 



100 \<<>l<h;y 

agents, in the operation of which the local exciting influence <>f 
arornatics is desirable. Cinnamon may be advantageously used 
in this way to improve the taste and make more acceptable to the 
stomach unpleasant remedies, ex-en when do other object exists. 
The pulverized hark may be given in the dose of fifteen (/reins; 
and in this form makes a very agreeable and effective gastric 
stimulant, in spasm of the stomach, or nausea. 

The virtures of cinnamon reside in a volatile oil, which is ob- 
tained separately by distillation. 

Oleum Cinnamomi — Oil of Cinnamon — is an aromatic pungent 
fluid, and may be given alone in the form of emulsion, made 
with gum or sugar, or mixed with preparations of tonic, cathartic 
or other remedies. The pungency of the oil is such as to render 
its use impracticable without such preparation. Undiluted, it is, 
indeed, a powerful local irritant, and not only excites the mouth, 
tongue and stomach unpleasantly, but when applied to the sur- 
face, acts promptly upon the skin as a rubefacient. 

The dose is one or two drops, rubbed up with surgar and tem- 
porarily suspended in water. 

Tinctura Cinnamomi — Tincture of Cinnamon — sometimes called 
Essence of Cinnamon, is made from the coarsely pulverized bark, 
and may be conveniently used [done or with other fluid prepara- 
tions, in which an aromatic excitant is desirable. 

Nausea, not dependent on gastritis, flatulent or spasmodic 
colic, and other painful conditions of the stomach and bowels, 
may be greatly relieved by this tincture in the dose of about hvo 
Jiuidrachms. 

Zingi BE R — Ginger. 

The root or rhizoma of zingiber officinale, an annual plant, with 
perennial root, native of Hindostan, and cultivated in many of 
the tropical islands, particularly the West Indies. 

The root, which is dug as the stem commences to wither, is 
first scalded to prevent germination and consequent decay, and 
dried quickly. These processes of preparation form the black 
ginger, so called, from the dark color of the surface. White ginger, 
or Jamaica ginger is manufactured from the same variety of the 



AND TIICRAPKUTICS. 



101 



drug, but changed in color by having the epidermis removed, 
and then subjected also to a bleaching process with acids, etc. 
This improvement in the appearance of the root does not add at 
all to the strength, but, perhaps, lessens its activity. Ginger, 
when deprived of the epidermis, is yellowish-white, has an aro- 
matic, not disagreeable odor, and pungent, pleasant taste. 




Zingiber officinale. 

Ginger is a popular aromatic carminative, used extensively for 
its local exciting effects upon the alimentary canal, in the condi- 
tions above described, requiring remedies of the class. It may 
be given in substance alone, or mixed with solid preparations of 
other medicines, with which an association is desirable, in the 
dose of fifteen grains. 

The root of ginger is sometimes collected before maturity, and 
of it is made, while in this tender state, a conserve by boiling 
with syrup. 

The virtues reside in a volatile oil and resinous substance, 
which constitute about five per cent., by weight, of the dried root, 



102 AC0L0G1 

and, when Beparated, form one of the officinal preparations of 
srineer under tin* name of 

Oleoresina Zingiberis — Oleoresin of Ginger, This concen- 
trated preparation possesses, in a high degree, the odor and pun- 
gency of ginger, leaving* the residue almost tasteless, [t should 
be well diluted lor administration, in order to prevent excessive 
irritation; and in the dose of one drop will produce the full effects 
of ginger. 

Tinctura Zirigiberis — Tincture of Ginger — is a convenient form 
for administration separately, or with other liquids, in conditions 
which require the action of aromatics, and may be given in the 
dose of forty drops. It is used more extensively, however, in the 
preparation of" 

Syrupus Zingiberis — Syi^up of Ginger — which is a very agreea- 
ble and useful preparation for administration with cathartic and 
tonic remedies, and may be given in the dose of one or two 
fluidrachms. 

Extra etum Zingiberis Fluidum — Fluid Extract of Ginger — is a 
concentrated solution of the active principles of ginger in alcohol, 
and differs from the tincture in being evaporated to greater con- 
centration. It may be used for the ordinary effects of ginger, in 
the dose of thirty drops. 

Infusum Zingiberis — Infusion of Ginger — is an extemporaneous 
preparation, and, though officinal, is made only when required 
for immediate use. Half a troyounce of the bruised or coarsely 
pulverized root, to the pint of water, affords the proper strength, 
to be taken in the dose of about tiro fluid ounces. 

This, like other aromatics, whose active properties depend 
wholly, or in part, upon volatile oil, should not be subjected to 
the process of boiling, which will dissipate the active ingredient, 
and leave a comparatively inert preparation, 

CA RYOPH YLLUS — C/ores. 

The unexpanded flower-buds of Caryophyllm aroniaticus, a 

small, beautiful tree, native of India, and found in most of the 
West India islands. In the preparation of cloves, the buds are 



AND THERAPEUTICS. 



103 



plucked and quickly dried, sometimes after having been scalded 
in hot water. In shape, cloves resemble small nails, are of dark 
color, fragrant odor and permanent pungent aromatic taste. 

Cloves are sometimes pulverized, and in this form may be used 
in the dose of ten grain*. Thus prepared, they are easily mixed 
with other medicinal agents in the pulverized form, such as 
cathartics or tonics, and given in substance or infusion. 

The active principle resides in a vo- 
tile oil obtained by distillation, and 
called 

Oleum Garyopkylli — Oil of Cloves. 
This amounts to one-fifth, in weight, of 
the cloves from which it is obtained. 
When fresh, the oil is a colorless li- 
quid, but becomes brownish-red, and 
thicker by time and exposure. The 
taste is aromatic and acrid, inflaming 
the mouth when taken undiluted. In 
the dose of three or four drops, rubbed 
with sugar or gum, and suspended in 
water, the oil may be administered for 
its aromatic stimulating action upon 
the stomach and bowels, in cases of debility of these organs, 
causing flatulence, etc. 

The oil of cloves has been a popular remedy for toothache, and, 
like other local irritants, it has the effect of destroying the sen- 
sibility of the exposed nerve in carious teeth, when applied by 
means of a saturated pledget of lint in the cavity. 

Mentha Piperita — Peppermint. 

The w T hole herb of Mentha Piperita, an annual, indigenous 
plant, cultivated in various parts of this country, and used in the 
fresh state for its aromatic properties. The virtues of the plant 
are obtained from the stem, branches and leaves. 

An Infusion, made by pouring water upon the fresh or dried 
herb, is sometimes used in nausea and other slight disturbances in 
the dose of two fluidounces. 




CavyophyUus aromatic us. 



104 A.C0L0G1 

The aromatic virtues reside in a volatile oil culled 
Oleum Mentha Piperita — Oil of PeppermvrU — and fehis, orsome 
of its preparations, is the form in which peppermint is usually 
administered. The oil may be taken in the done of two drops, 
rubbed up with sugar or gum and suspended in water. A more 
convenient form is that of the following preparation of the oil : 
Tincture Olei Mentha Piperita — Tincture of fin OH qf Pepper- 
mint, or Essence of Peppermint, as it is sometimes called. Tin's is a 
preparation which mixes readily with water, and may he con- 
veniently administered in the dose of fifteen or twenty drops. This 
is a popular remedy in ordinary nausea, and, when it depends on 
a relaxed and enfeebled condition of the stomach without local 
excitement, is, doubtless, a useful remedy. 

Mentha Viridis — Spear Mint. 

The herb of Merit I \a Viridis, a native of Europe, but cultivated 
in this country; growing wild, also, in various portions of the 
United States, in rieh, shady situations. In its botanical char- 
acteristics, this differs somewhat from the peppermint, but in all 
essential particulars the drugs are similar. It is recognized 
simply as mint, and has, perhaps, less pungency than pepper- 
mint. 

The active ingredient, forms of preparation and use are about 
the same as the preceding article, and, perhaps, requires no further 
separate description. 

Calamus — Sweet Flag. 

The root or rhizoma of. Acorus Calamus, an indigenous plant, 
and found, also, in various parts of Europe. It grows in low, 
moist situations, near small streams; and should be collected late 
in autumn or early in Spring. By drying, the root diminishes 
much in size, but is said to exhibit more of the aromatic proper- 
ties than when fresh. The odor is fragrant, and the taste pun- 
gent and aromatic, but in less degree than those already men- 
tioned. The root contains an essential or volatile oil and resin, 
upon which its virtues depend. 



AND THERAPEUTICS. 105 

An i) fusion, made with a pint of boiling water to a troyounce 
of the bruised root, may be used in the dose of two fluidounces. 
Calamus has the exciting influence of other aromatics upon the 

stomach and bowels, and is useful in painful conditions from 
flatulence and spasm of the alimentary canal. It is a popular 
remedy for the treatment of colic in young children, and may be 
readily and successfully given in the form of infusion, sweetened 
with sugar, to children of any age. 

Many other substances, not coming under the term aromatics, 
stimulate the stomach and excite temporary activity. 

Sinapis — Mustard — one of these, is used extensively as a con- 
diment for this purpose, and, also, to excite the appetite to the 
relish of nourishing food in sufficient quantity. Its local excite- 
ment upon the mucous surface of the stomach makes it a valu- 
able means with the therapeutist in arousing the organ to activity, 
when, from general torpor, its susceptibility to the influence of 
emetics is lost. 

Alcoholic drinks also have these effects. Brandy or whisky, 
taken before meals, increases the appetite, and in connection with 
or after the food, temporarily, promotes the function of digestion. 
This practice is, however, objectionable, on account of the liability 
to form a habit which often leads to moral and physical degre- 
dation. 

Cascakilla. 

The bark of Crotou Eleuteria, a shrub found in the Bahamas, 
aad native of the West Indies, whence the bark is obtained. 

This remedy is believed to possess a tonic action upon the di- 
gestive organs, in addition to the usual local effect of aromatics. 
The opinion once prevailed also that its tonic influence extended 
to the nervous system, as may be inferred from its having been 
substituted, in certain localities, for Peruvian bark, in the treat- 
ment of intermittent fever. It seems to be the settled opinion 
that some tonic effect is produced by it, yet without definite con- 
clusion as to the particular organ affected in this way. 

Infusum Cascarillw — Infusion of Cascarilla — may be prepared 



106 ACOLOG1 

alone, or with some gastric tonic, for its more speedy influence 
upon digestion; and given in the dost of about two fluidounoes. 

Lavandula — Lavender. 

The flowers of Lavandula vera, a small shrub, native of Eu- 
rope, and cultivated in this country. 

Lavender has, to some extent, the property of producing local 

excitement and warmth in the stomach and bowels, as other 
aromatics, but, being less active than many other articles of the 
class, is seldom used except as a deturgenl and vehicle for the 
administration of other remedies. 

Spiritus Lavandula — Spirit of Lavender — serves as a gentle 
gastric stimulant in painful spasmodic conditions of the stomach 
and bowels, but more particularly as a menstruum for elective 
remedies intended to affect the nervous system, in a manner to 
quiet painful spasmodic contractions. 

The seeds of Anise and Fennel, with their essential oils, are 
local excitants, and have the usual action of other aromatics. 

In a practical point of view, it would seem unnecessary to ex- 
tend the list of aromatics already given. Many other articles 
might be mentioned, whose carminative effects are undoubted, 
but with a short notice of those used more particularly for culi- 
nary purpose, the consideration of this class will be concluded. 

Condiments. 

Quite a number of aromatic local stimulants are used almost 
exclusively as condiments in the preparation of food. They not 
only improve the taste, so as to make it more palitable, but, by 
stimulating the stomach to increased activity, aid in digestion. 
Not only so, but when, taken freely they serve as apetisers, in- 
creasing the desire and relish for food. The propriety of their 
use in health is, therefore, questionable; for, if not embarrassing 
to the stomach when goaded into activity, may lead to unpleasant 
and even dangerous plethora. 

Pimenta — Pimento — Allspice. The unripe berries of Eugenia 
Pimento,, a moderately sized tree, native of the West Indies, and 




AND THERAPEUTICS. 107 

other tropical countries. Pimento may be taken, as other aro- 
matics, to excite gastric and intestinal activity, in the dose of thirty 
grains, but is used more frequently in the preparation of food 
and drinks. 

Piper — Black Pepper — the berries of Piper nigrum, a peren- 
nial climbing plant, and a native of 
India. Fig - 7 ' 

Black pepper, like common salt, is 
used almost invariably as a condiment, 
but may be given as a local stimulant 
of the stomach and bowels in the close 
of fifteen grains. 

Piperin, a crystalizable ingredient of 
pepper, has been lauded as the active 
principle of the drug; but there is now Piper nigrum. 

no doubt that upon the oily constituent 
depends the local stimulation produced by the remedy. 

Myristica — Nutmeg — the kernel of Myristica fragans, a native 
of the Molucca islands, is rarely used medicinally. 

Nutmeg, and Mace, the inner covering of the fruit, are mild 
aromatics, and used extensively for culinary purposes and drinks. 

An elective tendency to the brain follows the absorption of the 
active principle, and serious disturbance of its functions has been 
reported as the result of excessive quantities of these substances. 
In the dose of ten or fifteen grains they will be found to produce 
decided gastric excitement. 

Oleum Myristicce, a volatile oil upon which the exciting property 
of nutmeg depends, may be more conveniently and profitably 
used as a gastric or other local stimulant. The close is about tiro 
drops, and may be given by rubbing with sugar so as temporarily 
to suspend it in water, as in the use of other oils. 

Aurantii Cortex — Orange Peel — rind of the fruit of Citrus Au- 
rantium, has the property of gently exciting the gastric surface, 
but is rarely used except as an aromatic stimulant to conceal the 
taste and prevent the nauseating tendency of less pleasant reme- 
dies. The virtues depend mainly on a volatile oil, and it is not, 
therefore, subject to preparation by the boiling point of heat. 



108 ECOLOGY 

Vanilla. The prepared unripe capsules of Vanilla aromatioa, 
a climbing plant, native of the Wot [ndies, and other tropical 
regions. 

While vanilla possesses the local stimulating property in com- 
mon with other aromatics, and may be administered for the same 
purposes, it is more generally used to flavor ice cream, acidulated 
drinks, etc. It is supposed to possess also elective properties, by 
which the nervous system and, perhaps, the heart are excited to 
increased activity. 

Infusion is a form in which vanilla may be given. It is made 
with half a troyounce to the pint of boiling water. The do.se is 
half to a jiuidounce. 

Canella — the bark of Canella alba — a tree found in the West 
Indies, and, like other aromatics, may be used alone or with tonic 
and cathartic remedies, when local stimulation of the alimentary 
canal is desirable. This is sometimes necessary in order to pre- 
vent irregular painful contractions of the bowels during the 
operation of cathartics. It is used as a condiment by natives of 
the islands on which the tree is found. 

Goriandrum — Coriander — the fruit of Coriandrum sativum, a 
native of Europe. Coriander, though only moderately exciting 
to the stomach, may be used for this effect in the dose of thirty 
grabvi. Its chief use is in the preparation of food, to improve 
the flavor, etc. 

Cardamomwn — Cardamom — the fruit of Elettaria cardamo- 
rnwm; is extensively used in compound tonic and cathartic prepa- 
rations, and in culinary operations. Alone, as a gastric stimu- 
lant, for its carminative effects, cardamom is rarely used. 



AND THERAPEUTICS. 109 



SUB-ORDER II. 

LOCAL ACTION THROUGH CHEMICAL PROCESS. 



DIVISION I. 

REMEDIES THAT AFFECT ADVENTITIOUS SUBSTANCES 
AND STRUCTURES. 



CLASS I 

ANTHELMINTICS 



This term — from avrc, against, and £//^vc, a worm — is, in- 
tended to express the aetion of medicinal agents that destroy 
parasites inhabiting the alimentary canal, called worms. The 
result is generally brought about by a local influence upon the 
animal itself, without regard to any impression the remedy may 
make upon the human subject. Anthelmintics, however, in- 
clude certain mechanical means which are said to destroy worms; 
and, also, the remedies by which their expulsion, while living, is 
effected. Moreover, even the digestive tonic, which corrects a 
depraved condition of the alimentary secretions, in which the 
entozoa is said to take its origin, is included in the extended sig- 
nification of the term which heads this article. 

Cathartics, which may remove worms from the canal, and 
thereby cause their destruction, cannot, of course, strictly speak- 
ing, be called anthelmintics, and treated of as such. Their 
effects or results in this particular are altogether accidental. 
The same may be said of tonics, whose action is exerted upon 
the canal and its secretions, and incidentally destroy the elements 
in which the parasitic germ is nurtured. 

Either by chemical or vital affinity certain agents act upon the 
vital organs of the parasite, or chemically change the life-sus- 
taining element, so as to paralyze or otherwise cause its destruc- 
tion. 



110 &COLOI 

Anthelmintics thus acting upon the Living organism may 
justly be termed poisons to the entozoa, and the toxical Influence 
i- generally effected through chemical process. Worms which 
Inhabit the human Intestines arc of three principal species, viz.: 
tenia, lumbricoides and ascarides, with different varieties, partic- 
ularly of the former two species. All of these are said to be 
more or Less affected by the remedies known as anthelmintics; 
while, at the same time, it is conceded that certain articles arc 
better adapted to the destruction of particular species. 

Tenia — from valuta, a ribbon — are of two varieties, viz.: taenia 
solium, or long tapeworm, and tamia lata, which sometimes attain 
the immense length of a hundred feet or more. The tapeworm 
is made up of regular articulations, two lines thick, four wide, 
and from a fourth to half an inch in length; and it has been said 
that each is capable of maintaining independent existence. It 
is doubtless true, at any rate, that a number of articulations may 
be detached and discharged from the bowels, along with the 
caudal extremity, while the head and a portion of the body not 
only survive, but the latter actually increases in length by the 
reproduction of additional articulations. This worm inhabits 
alike the whole alimentary canal. 

The lumbrieoides — from lumbricus, the earth-worm, and eido:, 
likeness or form — found most frequently in children from one to 
six or eight years old, but sometimes in adults at any age. It 
attains the length of eight or ten inches, and inhabits the small 
intestines principally. The stomach and large bowel, however, 
are not exempt from its ravages. 

The ascarides — from aoicapi^a), to leap or kick — a very small, 
white, active worm, is not more than half an inch in length, and 
rarely found higher in the bowels than the rectum and lower 
part of the colon. The ta?nia and ascarides are found most fre- 
quently in adults. 

To determine symptoms by which the existence of worms may 
be known, is an important point connected with the consideration 
of this subject. There are many evidences of irritation in the 
alimentary canal, but unfortunately it is more difficult to ascer- 
tain its cause. Worms irritate the bowels and lead to certain 



AND THERAPEUTICS. Ill 

symptoms; undigested food and other irritating matters passing 
along the canal have the same effects. Those generally mentioned 
as indicative of worms, are: in children, tumid abdomen, irregu- 
lar appetite — sometimes voracious, at others delicate — disturbed 
sleep, picking the nose, grinding of the teeth, and convulsions; 
all of which may arise from intestinal irritation dependent on 
other causes than that of worms. The tapeworm and lumbri- 
coides produce somewhat similar symptoms in subjects of the 
same age, and those just given may be produced by either species. 
The ascarides, confined as they are to the lower bowels, rarely 
lead to other symptoms than the titillation and itching sensation 
felt in the rectum and anus. 

The observance of certain rules connected with the administra- 
tion of anthelmintics is considered important to their successful 
use. The addition of saccharine substances to all anthelmintic 
preparations is supposed to insure their being seized by the 
worms; and hence solids are given in the form of electuary, and 
infusions, decoctions, etc., well sweetened with sugar or syrup. 

A thorough purgative cathartic should follow the use of the 
worm poison, in order to rid the canal of putrid remains. This 
course is urged also under a belief that the worm often revives, 
after being stupefied by the remedy, if not carried out of the 
bowels while in this state. 

Catalogue of Anthelmintics. 

Spigelia, Bray era, 

Chenopodium, Rottlera, 

Azedarach, Hydrargyrum, 

Granati Radicis Cortex, Filix Mas, 

Pepo, Santonica. 

Spigelia — Pinkroot. 

The root of Spigelia Marilandica, an indigenous herbaceous 
plant with perennial root, found abundantly in Southern portions 
of the United States. Numerous fibrous roots are attached to a 



112 



ICOLOGY 



Pig. B. 



oommoD caudex, from which arise several stem- to the height of 
one or i wo feet. The flowers, which somewhat resemble the pink, 
give name to the plant. 

Pink root is an efficient and 

sale anthelmintic for the treat- 
ment of lumbricoides in chil- 
dren ; the taste not being such 
as to interfere particularly in 
its administration, nor the pois- 
onous effects upon the child, 
attributed to it, at all to he 
feared. A small yellow root, 
not so large as the spigelia, is 
sometimes gathered with the 
drug, and is believed to be the 
source of all unpleasant effect- 
ever witnessed in the use of 
pinkroot. Tt may be given in 
substance by mixing the pul- 
verized root with syrup, in the 
dose of sixty grains to an adult, 
and to children in doses pro- 
portionate to the age. 

Tafi is 1 1 m Sp igelke — // \ fi c s io 1 1 
of Spigelia — made by pouring 
a pint of boiling water on half 
a troyounce of the root, is a 
common extemporaneous prep- 
aration. A pint may be taken 
during the day, followed by- 
castor oil, or some other purga- 
tive, to discharge the worms 
while under the poisonous in- 
fluence of the anthelmintic. 
Extractor SpigeMa FluMum--Fhrid Extract ! of Spigelia— when 
properly prepared, contains all the activity of the drug, in much 
smaller bulk than the infusion. This is sometimes an important 




Sj/ir/etia. 



AiND THERAPEUTICS. 113 

consideration, owing to the difficulty found in administering a 
sufficient quantity of more bulky preparations. 

The dose is half a fluidounce every three or four hours, till two 
fluidounces have been taken, and followed as usual by some 

purgative. 

Chenopodium — Wormseed. 

The seed of Chenopodium Anthelmintic win, a common herba- 
ceous, indigenous plant with perennial root, found abundantly 
in most parts of the United States, and familiarly known as 
"Jerusalem Oak." The whole plant is said to possess anthel- 
mintic properties. The seeds only, however, are officinal, and 
afford one of our most popular indigenous remedies for the round 
worm in children. 

The pulverized seeds may be given, mixed with syrup, in the 
dose of sixty grains, and repeated once or twice during the day. 

Oleum Chenopodii — Oil of Chenopodium — a volatile oil, ob- 
tained from the seeds by distillation, contains their vermifuge 
property, and may be readily given in the form of emulsion, 
made by rubbing the oil with sugar and adding a little water. 

The dose is about half a fluidrachm, repeated as recommended 
for other articles of the kind. 

AZEDAEACH. 

The bark of the root of Melia Azedarach or China tree, a 
native of India, and cultivated as an ornament and shade in the 
southern portion of this and other countries exempt from severe 
frosts. Azedarach is highly esteemed as a domestic remedy in 
the treatment of worms; but its narcotic effects as a poison in 
over-doses deter many from its liberal use. 

A decoction — the form in which it is usually given — is made 
by boiling three or four troyounces of the bark from the root in 
a quart of water down to a pint. Of this, two or three fluidounces 
may be taken three times a day. 

Granati Kadicis Cortex — Bark of Pomegranate Root. 

The bark of the root of Punica Granatum P a small tree, native 
8 



114 ECOLOGY 

of China and the West-Indies, and cultivated in this country 

for its fruit ami the beauty of its flowers. 

The pomegranate is more celebrated as a remedy for tape- 
worm, though perhaps equally useful iu the treatment of other 
species. Not liable to produce alarming poisonous effects, and 
the fresh bark being generally readily obtained, it is surprising 
that more general use is not made of it, particularly since the 
vermifuge property is undoubted. 

A decoction, made by boiling two troy ounces of the bark in a 
quart of water down to a pint, is the form of preparation pre- 
ferred; and is given in the dose of four fluidounees, repeated three 
or four times a day, and followed by a purgative cathartic. 

Pepo — Pumpkin seed. 

The seed of Oacurbita pepo, or common pumpkin. The kernel 
of pumpkin seeds contains a fixed oil, upon which their active 
properties doubtless depend. They have gained some celebrity 
in the treatment of tapeworm, and may, probably, be used with 
equal benefit also for other species of worms. Being pleasant to 
the taste, they may be eaten without inconvenience when deprived 
of the outer covering or shell, and in this way patients mav be 
induced to take sufficient quantity to produce the anthelmintic 
effect of the seed. 

The pulp is sometimes rubbed up with sugar and water in the 
form of an emulsion, and taken in the done of tiro troyoimces, 
while fasting, and followed by castor oil or other purgative. 

Oleum Pepo — Oil of Py/mpJdn seed — is obtained by expression 
and, as has been said, probably contains all the anthelmintic 
virtues of the pulp. It has been used successfully in the treat- 
ment of taenia, in the dose of half a ffuidouncc, repeated in a 
few hours, and followed by a thorough purgative. 

Brayera — Koosso. 

The flowers and unripe fruit of Brayera anthelmintica, a small 
tree, native of Abyssinia, and growing on elevated situations where 
the flowers are gathered, dried and packed for shipment. They 



AND THERAPEUTICS. 115 

are pulverized and neatly bottled in France and other countries; 
and from Paris most of our supply is obtained. Koosso has a 
fragrant odor, and somewhat acrid, unpleasant taste. 

Fig. 9. 




Br ay era anthelmintica, Kunth. 
A. Flowering Branch. B. Bunch of Female Flowers. C. Flowers seen laterally D Fe- 
male Flowers ; a, b, c, d, e, the five outer segments of the calyx. 

Various attempts have been made to obtain the active princi- 
ple upon which its anthelmintic virtue depends, but without 
satisfactory results ; nor has the profession fixed upon any form 
of preparation for convenience of administration. It is cele- 
brated for its poisonous effects upon both varieties of tamia, and 



116 ICOLOGY 

although, until recently, very little used in this country, has 

!>een known ;i> a valuable remedy in tapeworm for more than 
the fourth of a century. The test- to which it has been sub- 
jected in this country for the lasl ten years, rally confirm the 
statements of Europeans, niosl enthusiastic in its praise. 

As no convenient preparation is afforded by pharmacopoeias, 

the powder is used in the form of simple mixture with water. 
Eight flu id ounces of hot water may he poured on half <itroii<>uu<-< 
of koosso, to form the usual extemporaneous preparation. After 

standing fifteen minutes, portions should he sweetened and swal- 
lowed at short intervals until all is taken, stirring well before 
each draught. -The effect upon the patient is sometime^ very 
unpleasant. Nausea and vomiting, with free catharsis, often fol- 
low its administration, and this effect upon the bowels, when 
produced, obviates the necessity of using purgative medicine to 
discharge the worm. 

ll( )TTLERA — Kameela. 

The fine granular powder obtained from the fruit capsule of 
Rotthra tindoria, a small tree, native of Hindostan and the East 
India Islands. The powder is collected by gently brushing the 
capsules, to which it adheres, and is of a reddish-brown color, 
without odor or taste. 

It is sold in commerce as a dye, and has attracted considerable 
attention on account of its anthelmintic virtues, reported by 
British Army Surgeons in India. 

Being an active cathartic and nauseant, in addition to its an- 
thelmintic property, like koosso, it may answer the 1 purpose of 
removing the worm after destruction by the poison. 

The use of kameela seems to have been confined, principally, 
to the treatment of tapeworm, and has long been known in 
India as a remedy for this parasite. Observations of its effects 
by practitioners in Great Britain, seem to have confirmed the testi- 
mony of army surgeons in regard to its value as a remedy, equal 
at least to koosso. 

\t may be given in the dose of about eighty grains, mixed with 
water or syrup. This quantity is considered sufficient to destroy 
the worm, and should be given in one portion. 



AND THERAPEUTICS. 



117 



A (metwre is proposed, made by macerating six troyounces of 
the powder in a pint of diluted alcohol. This is said to be more 
certain as a vermifuge and less unpleasant in its effects upon the 
patient. 

Hydra rg y r um — Mercury. 

Mercury, the subject of notices under the heads of Cathartics, 
Hepatico-salivary stimulants, and Catalytics, is also a valuable 
anthelmintic. It is poisonous to other parasites than those which 
inhabit the alimentary canal ; and may be truly called an anti- 
parasitic. So far as tested, it proves poisonous to every kind of 
vermin, insect and worm infesting the human body. Vermin 
which prey upon the surface; the acarus, sarcoptes hominis, 

Fig. 10. 




Sarcoptes Hominis.— (Ra*pail.) 

or itch mite, which burrows in the skin ; and the several species 
of worms which inhabit the bowels, are alike destroyed by this 
remedy. Reasoning from analogy, the trichina may be also 
subject to this poison, could it be made to reach its location 
in sufficient quantity. 

Authors have expressed the opinion that the destructive action 
of certain preparations of mercury upon entozoa is due more to 
other ingredients which enter into the preparation than to the 
mercury itself. To the lard, for instance, of mecurial ointment, 



US ICOLOGl 

has been attributed its destructive effect upon vermin and the 
itch insect. The theory of* [t8 action was predicated upon the 
reputed fad that oily substances destroy certain insects and 
worms, by occluding the respiratory tubules opening on the sur- 
face, through which the animal receives oxygen. If no other 
than oily preparations of mercury proved effectual, as an anti- 
parasitic, the theory would appear more plausible. Such, how- 
ever, is not the ease. All the preparations, so far as tested, pos- 
sess this property, and have been used successfully for the de- 
struction of all the parasites above mentioned. 

Hydrargyri Chloridum Mite — Mild Chloride of Mercury — Cal- 
omel — is valuable as a vermifuge, not only on account of its 
poisonous effects upon the worm, but also from its cathartic ac- 
tion, and its supposed sedative influence over nervous irrita- 
bility. Alarming nervous symptoms are sometimes produced 
in children, leading to convulsions, by reflex action from the 
irritation of worms in the alimentary canal; and sedative doses 
of calomel, it is thought, not only put a quietus to the irritating 
cause, but also allay nervous susceptibility, by a sedative influ- 
ence on the brain. It is, therefore, selected as a vermifuge under 
such circumstances, and used in large doses. For this purpose, 
from twenty to thirty grains should be given in syrup or sugar 
and a fluidounce of castor oil in a few hours thereafter, should 
the bowels not be thoroughly evacuated by the calomel. 

Ungaentum Hydrargyri — Mercurial Ointment — may be used 
successfully for the destruction of internal and external parasites. 
The several varieties of lice and itch insect are readily destroyed 
by a few applications of this ointment, to parts of the body in- 
fested by them. Though not usually given internally for any 
purpose, it has been known to have very happy effect in destroy- 
ing the round worms when thus administered. An account is 
given of sixty or eighty grains having been taken through mis- 
take, and followed by the discharge of a large quantity of worms 
from the bowels. 

Hydrargyri Chloridum Corrosiruin — Corrosive Chloride of Mer- 
cury — Corrosive Sublimate. This preparation is not suited to 
internal use as a vermifuge, on account of its irritating proper- 



AND THERAPEUTICS. 



119 



tics. Injury may be done the mucous membrane of the bowels 
by it, equal to that produced by the worm. Applied to the sur- 
face, however, it proves an efficient remedy in scabies, and, 
although not generally used for the destruction of lice, will 
probably answer well for this purpose. Two or three daily ap- 
plications of a solution, in the proportion of two grains to the 
fluidounce of water, to parts affected with acarus, or itch insect, 
are generally successful in their destruction. 

Filix Mas — Male Fern. 

The rhizoma of Aspidium Filix Mas, an annual plant, with 
perennial root, native of Europe and America. It consists of 
several leaves or fronds, rising to the height of a foot or more, 




Aspidium filix mas.— Fresh rhizome entire. 
a. Spirally-coiled young frond, bhb. Foot-stalks of the older fronds, c c. Root-fibres. 

and a caudex with the remains of former leaf-stalks. This con- 
stitutes the drug in question, and comes to us in fragments of 
the scathe along with the root. 



L20 ACOLOG* 

Fern has long been considered a valuable remedy in tapeworm, 
and extensive use of it for this purpose, in Europe, furnishes 

ample testimony of its value as an anthelmintic. Other and 
more recently discovered remedies for this formidable worm have 
almost superseded it, however, in this country; more, perhaps, 
from the enchantment of novelty than otherwise. The powder 
may be given in the dose of one hundred and twenty grams, in 
the form of electuary. 

Extr actum FilicLs Liquidum — Liquid Extract or Oleoresin of 
Fern — is the only officinal preparation in this country, and may 
be given in the dose of about forty drops. 

x Santonica — Levant Worrnseed. 

The unexpanded flowers of Artemisia Cina. The name would 
seem to imply that the seeds, instead of the flowers, constitute 
the drug in question, but it is found composed of the radicles 
and unexpanded dried flowers of the plant. The dose in sub- 
stance is thirty grains, in the form of electuary. It may be given 
also in the form of non-officinal Infusion. 

Santoninum — Santonin — the active principle of the flowers, is 
in colorless, inodorous and nearly tasteless crystals, soluble in 
chloroform, sparingly so in alcohol and ether, but insoluble in 
cold water. 

The physiological action on the human organism is not posi- 
tively ascertained, but, from certain symptoms known to follow 
its use, such as derangement of vision as to colors, and narcot- 
ism, it is supposed to act powerfully on the brain in large doses. 
As an anthelmintic, santonin is supposed to possess all the vir- 
tues of santonica, and is considered one of the most valuable 
articles of the class. Its insolubility prevents ready absorption, 
and allows its passage along the canal, where it comes in contact 
with the worm and poisons it. It is used only as an anthel- 
mintic, and the dose is about fire grains, with syrup or sugar, and 
proportionately less for children. 

Santonin is a popular remedy with German families of this 
city, and is now considered one of the most reliable anthelmin- 
tics, by many of our American as well as German physicians. 
It is used more particularly for lumbricoides in children. 



AND THERAPEUTICS. 121 

CLASS II. 

ESCHAROTICS. 

Articles of this class, as the name implies, are intended to 
produce complete destruction of the parts to which they are ap- 
plied — the sound as well as unsound tissue. Their use as a 
means of counter-irritation, however, though formerly practiced, 
is now measurably discarded. Issues made by setons, blisters, 
and the like, being considered preferable to the moxa, caustic, 
etc., are generally selected for this purpose. 

Escharotics — from sayapoco, to scab over — are more particu- 
larly useful in the destruction of fungous granulations on ill- 
conditioned ulcers and unhealthy wounds; and also the eradica- 
tion of cancerous tumors, and various other adventitious growths. 

Catalogue of Escharotics. 

Potassa, 

Cauterium Actuale, 
Acida Minerales. 

Potassa — Caustic Potassa. 

This caustic alkali is, chemically, a hydrate of the protoxide 
of potassium, dry potassa being simply a protoxide of this metal. 
It is found in solid sticks of grayish color, deliquescent, dis- 
solving in less than its weight of water, and very caustic. In 
order to its preservation in the solid form, it is necessary that it 
be kept in well-stopped bottles. 

Caustic potash is a powerful escharotic, rapidly destroying the 
vitality of even healthy structures, when placed in contact with 
them ; and has been used as a counter-irritant in the formation 
of issues by the destruction of sound tissue. 

Fungous granulations and other unnatural growths may be 
destroyed effectually by the application of the solid caustic. Care, 
however, is necessary in order to protect contiguous sound parts 
from its action, as it readily dissolves by contact with moist 
tissue, and runs along the surface to neighboring parts. After 



122 ACOLOGl 

touching the structures t<> be destroyed, therefore, the part should 
be washed, or wel with vinegar to neutralize the caustic 

Cauterium Actualb — Actual Cautery. 

Heat applied in any way may be termed actual cautery, but 
it is only when in a degree sufficient to cause death of the part, 
at once, that it comes properly under this title. Hot metals, or 
substances in a state of combustion, destroy Living tissues, and 
are, therefore, escharotics. Iron at a red heat causes death of a 
part instantly, with less pain than when applied at a lower 
temperature; and although great dread of its application is en- 
tertained, the actual cautery is less objectionable than any caustic 
or mineral acid, for the destruction of unhealthy tissues. The 
effect is prompt, decisive, and the action limited to the point of 
application. Hemorrhage, which may result from the use of 
the knife or other escharotics, need not be feared from it. The 
fact is known, also, that hot iron gives less suffering than other 
articles of the class ; and, as it may be used without affecting 
contiguous sound parts, seems to have advantages over other 
escharotics. The tough fibrous, insensible structure so trouble- 
some in hospital gangrene, may be effectually removed without 
injury to the surrounding sound tissue, liable to occur from the 
application of fluid escharotics. The aversion, however, on the 
part of patient and friends, to so formidable a remedy, often in- 
terferes with its use. 

Acida Mixerales — Mineral Acids. 

Concentrated mineral acids are powerful escharotics, destroy- 
ing organized structures promptly and perfectly. They arc 
used in chronic and phagedenic ulcers, gangrene, etc., to remove 
the unhealthy and irritating mass found in them. Hemorrhoidal 
tumors and unnatural growths may also be destroyed in this 
way. 

Acvdum Nitricum — Nitric Acid — is generally preferred, and 
almost exclusively used for the immediate destruction of soft 
tissues. It is applied by means of saturated lint placed in con- 



AND THERAPEUTICS. 123 

tact with the part to be acted on. Care is, however, necessary 
in order that injury be not done to neighboring sound structures. 

Acidum Arsenicum — Arsenic Acid — included under the above 
head, is an escharotie of considerable power. Unlike that of 
the mineral acid above named, its eifects are produced slowly, 
causing pain, swelling, and other inflammatory symptoms. 

For its destructive action upon tumors of every variety, falling 
into the hands of certain charlatans, this substance is used, and 
forms the basis of most secret cancer remedies. In its action for 
this purpose, though effective in the destruction of tumors when 
introduced into them, it is more tedious and painful, and less 
certain than extirpation by the surgeon's knife. 

Acidum Chromicum — Chromic Acid — chemically the teroxide of 
chromium, is in the form of red, deliquescent crystals of metal ic 
taste and soluble in water. Chromic acid is a powerful escharotie, 
penetrating deeply but slowly, without producing much pain. 

It is used in the form of solution in the strength of about 
eighty grains to the fluidounce of distilled water, for the destruc- 
tion of organized tissues in the form of morbid growths, phage- 
denic ulcers, gangrene, etc. 

CLASS III. 

ANTISEPTICS. 

Substances which prevent decomposition or putrescence are 
called antiseptics — from avzc, against, and a/jmo, to putrefy. 
There are many articles said to have this effect; some of which 
are used, not so much to prevent putrefaction, as to destroy the 
unpleasant odor and supposed contaminating influence of exha- 
lations from the bodies and excrements of those affected with 
malignant disease. These are used extensively as disinfectants in 
hospitals, water closets, sewers, etc. It is supposed that cholera, 
typhoid fever, and other epidemic infectious diseases, are restricted 
in their ravages by the proper use of this, with other sanitary 
means. 

A tendency to putrescence in the blood is, by some, supposed to 
exist in certain forms of adynamic fever, and antiseptic remedies, 



m 4C0L0G1 

therefore, required in their treatment. The correctness of this 
theory, however, we are not prepared to admit. It i^ a fad no- 
ticed by the most casual observers, that patients Buffering from any 
malignant disease, with great nervous prostration, emit through 
all the emnnetories — the skin, bowels, Lungs and kidneys — odors 
more or less fetid. In such eases the breath, perspiration, al vine 
evacuations, and sometimes the urine exhibit this peculiarity. 
Dark fur upon the tongue, and sordes around the teeth and gums 
are but the deposit of putrid pulmonary transpiration. Under 
such circumstances antiseptics would seem to be called for, and 
doubtless will, in a great degree, change the character of these 
discharges; but all such facts do not, by any means, prove that 
a morbid condition of the blood itself is the origin of such dis- 
eases. Putrescence is the result of decay or decomposition of 
organized auimal structures, and when it commences in a part, 
whether from a want of nervous or sanguineous support, absorp- 
tion of fetid gaseous principles, extricated by this process, also 
commences. The blood, though healthy, receives these impuri- 
ties by absorption, and depuration occurs through the emuncto- 
ries. Hence the odor of discharged fluids in diseases destroying 
the vitality of certain structures. Malignant scarlatina is a 
striking example of this kind of disease. From destructive in- 
flammation of the tonsils and other parts, putrifaction results; 
the blood becoming loaded with decomposed tissues, and the ex- 
halations fetid, from the depuration of this offensive material. 
The same symptoms, in these respects, occur after serious injuries 
from which gangrene or putrifaction results. Black tongue, 
sordes and putrid odor of exhaled fluids, are not uncommon in 
extensive gangrene from this cause. Adynamic fevers, in which 
vital or nervous po\ver is deficient, probably leads to decomposi- 
tion of certain structures and the evidences of putrescence pro- 
duced thereby, instead of having primary origin in the blood. 

In typhoid fever perhaps lesions always exist, when the above 
symptoms of putrescence ensue — lesions which originate not iu a 
morbid agent in the blood, but in a want of energy in the nerves 
of organic life, by which the decomposition of solid tissues occurs. 

From what has been said, it cannot be inferred that any deci- 



AND THERAPEUTICS. 125 

dedly curative effect need be expected from antiseptic remedies. 
By their use, however, structures may be afforded greater power 
to resist the putrefactive process, and thereby more time given 
for the restoration of vitality in the part. 

Catalogue of Antiseptics. 

Creasotum, Chlorine, 

Acidum Carbolicum, Carbo Ligni, 

Calx. 

Creasotum — Creosote. 

Creasote — from tcpea<;, flesh, and crco^co, to save or preserve — is 
of vegetable origin, being obtained from wood-tar, and is entitled 
to a prominent position in the class of antiseptics. The name ? 
literally implies to save flesh, but the remedy may, from its pun- 
gency and penetrating odor, only prevent any impression upon the 
organs of taste and smell, by less exciting substances. In this 
way putrid gasses may be rendered inoffensive, without being 
neutralized by chemical combination. 

The power to prevent decomposition, however, is unquestion- 
able. It is nothing more nor less than the action of vegetable 
creasote that is sought in the practice of smoking meats for their 
more perfect preservation, after having undergone the salting 
process. 

Creasote being a powerful local irritant to the alimentary mu- 
cous membrane, has been considered a dangerons remedy used 
internally in quantity above the ordinary dose of one or two 
drops ; but in hospital practice during the late war, it was ascer- 
tained that in the dose of thirty and even forty to fifty drops, the 
remedy was not only tolerated, but proved salutary in protracted 
cases of enteritis. Much of its good effect in this condition is 
doubtless due to local action upon the relaxed and inactive state 
of the mucous surface, but w 7 e must not loose sight of the fact 
that in low forms of protracted disease septaemia is likely to occur, 
requiring antiseptic means carried into the circulation. The or- 
dinary dose is two to five drops rubbed up with gum or sugar and 
suspended in water. 



126 ACOLOGV 

Acidi'm Carbolicum — Carbolic Acid. 

This substance, already mentioned as a prominent catheretic 
is obtained by distillation from coal-tar, and is possessed of deci- 
dedly antiseptic and disinfectant properties. 

The present system of embalming dead bodies by the injection 
of antiseptics into the arteries may he carried out with perfect 
success with this article. ( hie troyounce of the acid to half a gallon 
of water, injected so as to fill the arteries, and repeated in twelve 
hours, will effectually prevent decomposition. A body treated 
in this way may be preserved for any number of years, and if 
kept immersed in liquid, without perceptible shrinking or loss of 
bulk. If exposed to the air it becomes hard and firm from des- 
iccation, but without putrefaction or loss of tissue. 

Doubtless much of its effects in ulceration, attributed to cather- 
etic action, is due to antiseptic power, in preventing decomposi- 
tion of fibrin and formation of pus. In the dose of two grains 
three or four times a day, the fluids of the body become suffi- 
ciently impregnated with the remedy, for its general antiseptic 
effect. 

Calx — Idme, 

' This alkali, treated of under the head of antacid catalytics, is 
also antiseptic, and used extensively as a disinfectant in privies, 
sewers, and other filthy locations from which noxious and un- 
pleasant gasses emanate. 

Calx Chlorinata — Chlorinated Lime — called also Chloride of 
Lime — is a combination of the two valuable antiseptics, lime and 
chlorine. This is in the form of a moist grayish mass, and is 
celebrated for its bleaching and disinfecting properties. 

Chlorine. 

This elementary gaseous fluid, whether dissolved in water, in 
the form of chlorinated water, united with hydrogen in the form 
of muriatic acid, or combined with metalic and alkaline bases in 
the form of chlorides, is a universally acknowledged and highly 
prized antiseptic. 



AND THERAPEUTICS. 127 

Aqua CMormii — Chlorine Wafer — is made by the solution of 
chlorine gas in water, and may be used internally in the dose of 
two or three fluidrachms. It may be applied locally as an anti- 
septic or disinfectant, to cancers and other foul ulcers, and as 
a gargle in malignant sore throat. 

Acidam Muriaticnm — Muriatic Acid — in the dose of three or 
four drops, well diluted, may be used internally as an antiseptic, 
but is generally given in the following combination with iron : 

Tlnctura Ferri Chloridi — Tincture of Chloride of Iron. It may 
be applied to putrid ulcers, gangrene, etc., in full strength, and, 
internally in the dose of twenty drops diluted with water, for its 
antiseptic effects on putrescence in the alimentary canal. 

Sodii Chloridum — Chloride of Sodium — common salt, though 
universally selected in domestic use, and by packers for the pre- 
servation of meats, is rarely given as an antiseptic in medicine, 
but its disinfecting property is made available in the liberation 
of chlorine by decomposition with sulphuric acid. In this way 
it is used in sick rooms for the purpose of destroying unpleasant 
odors emanating from the subjects of malignant disease. 

Liquor Sodas Chlorinates — Solution of Chlorinated Soda. This 
solution is a popular antiseptic, as a local application for various 
unhealthy and offensive wounds, ulcers, etc., and as a disinfectant 
to destroy putrid and unpleasant vapors of the sick room. It is 
used for these purposes, ordinarily, in the full strength of the 
preparation. 

Zinci Chloridum — Chloride of Zinc — is useful as a catheretic 
and antiseptic in its local application to ulcers and chronic in- 
flammation, in the strength of five grains to the fluidounce of water. 
For the preservation of dead bodies, in the manner above de- 
scribed, in the use of carbolic acid, chloride of zinc is successfully 
introduced, in the proportion of sixty grains to the pint of water. 

Carbo Ligni — Chctrcoal. 

Charred wood, by its absorbent property, is rendered valuable 
as a disinfectant for external application. Poultices, composed 
in part of charcoal, applied to gangrenous parts, and foul ulcers, 



128 LCOLOGl 

destroy their fetid odor by the absorption of offensive gases 
emanating from deseomposed tissue-. Putrid liquids may also 
be purified by filtering through charcoal, which retains the septic 

principles and unpleasant gases contained in them, and allows 
the clear liquid to pass into the vessel below. 

Various other substances possess antiseptic property, but these 
constitute the most prominent articles of the class. 



AND THERAPEUTICS. 129 



SUB-ORDER III. 

LOCAL ACTION THROUGH MECHANICAL PROCESS. 



DIVISION I. 



REMEDIES THAT AFFECT THE INTERNAL AND EXTERNAL 
SURFACES. 



CLASS I. 

DEMULCENTS 



This is an important class of remedies, and yet they produce 
no chemical or vital action whatever. 

Demulcents — from demulceo, to soothe — are bland, unirritating 
substances, and used for their mechanical influence in protecting 
denuded and inflamed surfaces — externally and internally — from 
contact with irritating causes. 

The skin, when deprived of its cuticle, is liable to excessive 
irritation from exposure to the atmosphere, and by being covered 
with demulcent substances an artificial cuticle is formed, which 
temporarily protects it from injury. The same may be said of 
an irritable or inflamed mucous surface ; and though the applica- 
tion cannot be made so satisfactorily, as to the skin, yet the class 
affords our best means of relief in such condition of the alimen- 
tary mucous membrane. 

The treatment of gastritis and enteritis should be commenced 
and terminated with the liberal use of demulcent drinks. They 
are used not only in disease of the mucous membrane lining the 
alimentary canal, and the denuded surfaces externally, but also 
of those to which they cannot be directly applied, as that of the 
bronchia and urinary organs. Hence, in nephritis and bronchitis, 
demulcents are administered by the stomach, and it is thought 
with decided advantage. It is not reasonable to suppose, how- 
9 



130 LCOLOGI 

ever,tha1 any very decided influence can be exercised in this way 
after the demulcent has been absorbed into the circulation. Pro- 
bably all the benefit is derived from the diluent with which it is 
given. A plausible explanation of its effects upon the respiratory 

tube is, that the remedy coming in contact with the mucous mem- 
brane of the mouth and throat impresses it, and from sympathy 
of continuity the membrane in the larynx, trachea, etc., is also 
soothed. Whether to this extent such influence be exercised or 
not, it is quite certain that demulcent substances held in the 
mouth, and suffered constantly to pass into the throat, do allay 
the tickling ssensation and cough, from irritation of the larynx. 
While the mechanical effects upon the kidneys, from their inter- 
nal use, is doubtful, the fact cannot be denied that large draughts 
of demulcent infusions tend greatly to allay irritation in the 
urinary passages. This may depend, as above suggested, upon 
repletion of the blood vessels, causing an increased amount, and 
consequent dilution of the urine, which lessens its acrimony and 
tendeney to irritate the mucous membrane in its passage from 
the kidneys. 

Catalogue of demulcents. 

Acacia, Amylum, 

Linum, Glycerina, 

Ulmus, Althaea, 

Chondrus, Symphytum, 

Cetraria, Oleum Olivse, 

Sesamum, Bismuthi Subnitras, 
Sassafras Medulla. 

Acacia — Gum Arabic. 

The concrete exudation from the branches of Acacia Vera, and 
several other species of acacia. Most of these species are trees 
of medium size, and inhabit various parts of Africa. The juice 
exudes spontaneously from the branches, and concretes upon their 
surface. Incisions, however, which are sometimes made, facili- 
tate its discharge. There are several varieties of gum in com- 



AND THERAPEUTICS. 131 

riaerce, taking' their names principally from the place of exporta- 
tion. They do not differ in any essential particular, and all, or 
nearly so, furnish the gum of commerce. 

Gum arabic, as received by Druggists in this country, is in 
small, irregular shaped masses or fragments, differing in shades 
of color, from nearly white to brown, without decided odor or 
taste, and is soluble in water, forming a viscid mucilaginous fluid. 
The pulverized gum is white, and when exposed to the atmos- 
phere, for some time, absorbs moisture, and on drying becomes 
hard. In order, therefore, to preserve it in the form of powder 
for any length of time, it must be excluded from the air. 

Mucilago Acacice — Mucilage of Gum Arabic — according to the 
United States Pharmacopoeia, makes a solution too thick for a 
demulcent drink, but having the gum dissolved in this strength, 
one fluidounce is sufficient for half a pint of water, or other 
liquid with which it is desirable to administer the mucilage. A 
drink for ordinary demulcent purposes may be made by stirring 
till dissolved, sixty grains of pulverized gum in half a pint of 
water. With this may be mixed any anodyne or astringent ne- 
cessary to the treatment of dysentery, gastritis, etc., and the 
mixture can be used by the rectum or stomach as may be neces- 
sary. It is a valuable vehicle for the application of catheretic 
and astringent remedies to local diseases generally. The fact 
must, however, be borne in mind that, subacetate of lead and 
alcohol precipitate the gum from its solution, and borax coagu- 
lates it. They are, therefore, incompatible. Dilute acacia mu- 
cilage, or gum water, cooled with ice, is an agreeable and useful 
drink in gastritis, or inflammation of any portion of the mucous 
membrane lining the alimentary canal. If rejected immediately, 
it should be repeated until the excitement of the stomach is 
allayed. In acute enteritis, the drink should consist almost ex- 
clusively of this or some other demulcent. 

Linum — Flaxseed. 

The seed of Linum usitatissimum, or common flax, an annual 
plant, native of Egypt, and cultivated in this and most other 



132 ACMl.Ml.Y 

countries. These well known seeds are of a glossy brown ap- 
pearance, covered with gummy substance, soluble in water, and 
upon which their demulcent property depends. 

Flaxseed can be \i><-d profitably in the various diseases for the 
treatment of which demulcents are servicable, but in nephritic 
and bronchial inflammation this particular agent is considered 
most appropriate. When obtained free from litter, the mucilage 
is soothing, and protects denuded surfaces from contact with the 
atmosphere, and other irritating causes. 

An Infusion of Flaxseed may be made by pouring a pint of 
hot water on half a troyounce of the seed. After macerating an 
hour, stir and strain. This, though not officinal in the United 
States, is the preparation in general use as a demulcent. In 
nephritis, cystitis and urethral inflammation, large draughts of 
this infusion moderate the irritation of the mucous membrane, 
perhaps by diluting the urine, more than from demulcent protec. 
tion. Kenal sedatives given under such circumstances are generally 
administered in this infusion. It is thought that in bronchial 
inflammation, also, the remedy, taken in small quantity, fre- 
quently, is decidedly beneficial in relieving the irritability of the 
respiratory mucous membrane, perhaps by sympathy of continuity. 

Infusum Lini Compositum — Compound Infusion of Flaxseed — 
is an officinal preparation of flaxseed and Liquorice root, in 
which is afforded one of the most useful demulcent drinks in an 
irritable or inflamed condition of the alimentary mucous mem- 
brane. 

Ulmus — Slippery Elm Bark. 

The inner bark of Ulmus Fulva or Slippery Elm, an indig- 
enous tree, growing in swamps and other low situations in 
most of the Southern States. Slippery Elm imparts to water 
its mucilage, forming an agreeable and useful demulcent drink 
in all manner of bowel affections, connected with the mucous 
surface, and may be used, ad libitum,, in enteritis as manifested 
by dysenteric or diarrhoeal symptoms, either alone or as a vehicle 
for the administration of other fluid remedies, by the mouth or 
rectum. 



AND THERAPEUTICS. 



133 



The Infusion or mucilage may be made by adding a troyounce 
of the bruised bark to a pint of water. The constant use of this 
infusion not only soothes and protects the mucous surface of the 
bowels from injurious contact with fiecal and other matters, but 
aifords a species of nourishment, from which support to the sys- 
tem may be derived for a time, it is said, without other food. 
Hence the importance of this drink, in liberal quantity, during 
the progress of bowel affections, when ordinary food cannot be 
properly digested, and by passing along the canal, in this state, 
leads to aggravation of the disease. Infusion . of elm may be 
used as collyria, containing such other ingredients as may be re- 
quired, except acetate and subacetate of lead, which are incom- 
patible, causing the mucilage to precipitate from its solution. 



Chondrus — Irish M< 



OSS. 



The lichen, chondrus crispus, found 
on the coast of Ireland, and also of 
the United States, bordering on New 
England, is collected from rocks, or 
the beach, where it is drifted during v=na 
stormy weather, and dried in the sun. 
This lichen, called also carrageen, is 
demulcent and nutritious. Carra- 
geenin has been proposed as the name 
for the demulcent ingredient, which 
differs in some respects from gum. 



Fig. 12. 




Chondrus malillostis. 



Portion of the channelled frond hear- 
ing the pedicellate capsule*. 



Cetraria — Iceland Moss. 

The entire Lichen of Cetraria Islandica, found in this country 
and various parts of the world, in northern latitudes. To the 
mucilaginous aud nutritious principle it contains, the name 
IAchenin has been given. 

These Lichens are adapted to the treatment of low forms of 
disease, in w T hich the bowels are the principal point of disturb- 
ance. Epidemic dysentery, diarrhoea and typhoid fever, gen- 
erally require demulcent fluid diet, which affords the greatest 



1:5 1 



ICOLOGl 



amount of nourishment, without leaving irritating faecal matter. 

These articles, it Is believed, afford considerable nourishment, 

in the mucilage prepared from them. 

A decoction of either of these lichens 
may be made by boiling half a troyounce 
of the moss in ;i pint and a half of wa- 
ter or milk, down to a pint. When the 
milk is used for the decoction, no other 
nourishment is necessary in prostration 
from bowel affections. The amount to 
be taken must, of course, he determined 
by the capability of the stomach to retain 
and digest it. 

Sesamum — Benne. 

Cetraria islandica. 




The apotJiecia on the- larger 
lobes of the thallus. 



The leaves of Sesamum Tndicum, an 
annual plant, four or five feet high, na- 
tive of the West Indies, and cultivated 
in Asia, Africa and the United States. The leaves contain a gummy 
substance, which they communicate to water, forming a viscid 
infusion and valuable demulcent drink. • Three or four fresh 
leaves from the plant, stirred in a pint of cold water, afford the 
proper strength of infusion, which may be taken ad libitum, in 
bowel affections, as an ordinary drink, to assuage thirst and dilute 
the blood.' The soothing demulcent influence is, at the same 
time, beneficial to the inflamed mucous membrane. It has been 
extensively used in domestic practice, with children having dys- 
entery, cholera infantum, etc. 

Sassafras Medulla — Sassafras Pith. 

The pith of the branches of sassafras officinale, a small indig- 
enous tree, found in all parts of the country, and, it is said, also 
in South America. The pith is white, spongy, light, and con- 
tains a gummy substance, which it yields to water, forming a 
clear mucilage. 

It is one of the best demulcent applications to delicate sensi- 
tive structures, and is, therefore, highly beneficial in the treat- 



AND THERAPEUTICS/ 135 

ment of ophthalmia, for which it is extensively used in practice. 
As a vehicle in the application of other remedies, in acute or 
chronic conjunctivitis, it serves a valuable purpose. Even alone, 
with the exclusion of light, the soothing influence of this demul- 
cent acts favorably in sore eyes. 

The Iiifitsion is made by pouring a pint of hot water on one 
hundred and twenty grains of the pith. Mascerate an hour — 
stirring occasionally — and strain. This preparation may answer 
well for the usual purposes of demulcents, as above stated, as an 
application to the inflamed conjunctiva. 

Amylum — Starch. 

The fecula of the seed of Triticum Vulgare, or common wheat. 
This article, of such general use in laundries, and as a chemical 
test, is also nutritious and demulcent; and although not exten- 
sively used for these properties, is sometimes given by enema, 
with opiate and astringent preparations in dysentery. It is 
readily dissolved by hot water, and in this way is prepared for 
medicinal use. 

Glycerina — Glycerin. 

A sweet principle obtained from fats and fixed oils, (Br.) 
Glycerin (from y/jjfcuz, sweet) is a clear, unctuous fluid, of 
sweetish taste, and almost without odor. Although discovered 
nearly a century ago, it has only recently been brought into gen- 
eral use as a remedy. Its demulcent property, and great solvent 
power, render it a valuable addition to the list of material agents. 
Like other new remedies, however, its virtues have been exag- 
gerated, particularly, in the attempt to substitute it for calorific 
nutrient means, used in tuberculosis. 

As a demulcent for internal use, glycerin is in general use only 
when combined with catheretic, and other remedial means in the 
form of glycerole, a French term applied to the solution of any 
substance in glycerin, or glycerite, as expressed in the United 
States Pharmacopoeia. The glycerites of carbolic acid, tannin, 
etc., not only answer the purposes of catheretics and'astringents, 



136 .\<olo<;\ 

but also thai of a demulcent. The glycerin, in such preparations, 
serves the double purpose of excipient and soothing agent; the 
latter being highly important in the treatment of lesions con- 
nected with the alimentary mucous membrane. Carbolic acid, 

iodine, bromine, morphia, and many other valuable remedies are 
readily dissolved by it; making perfect solutions, and the addi- 
tional advantage of demulcent property. Externally the appli- 
cation of this substance is more extensive. 

Being slow to dry when exposed to the air, glycerin serves as 
protection to denuded parts, and is extensively used as a cover- 
ing to superficial injuries, and by surgeons as a dressing for 
wounds and surgical operations. Dry, scaly eruptions; dryness 
of the membrana tympanum, from concrete cerumen ; and general 
dryness of the skin, with tendency to chap, are all fit conditions 
for its use. Cotton or lint saturated with it, and applied to the 
os uteri when, indurated, engorged and irritable, is said to afford 
very considerable relief. 

Ai/THiE A — Mai •shmallow. 

The root of Althcea Officinalis, or Marshmallow. 

Symphytum — Comfrey. 

The root of Symphytum Officinale, or Comfrey. 

The roots of these plants contain mucilage in considerable 
quantity, which they yield readily to water, and a decoction 
affords a demulcent drink, perhaps equally useful with more 
prominent articles of the class. 

Gleum Oliv^e — Olive Oil. 

The fixed oil obtained from the fruit of Olea Enropwa, a small 
evergreen tree, fifteen feet in height, native of the Levant, and 
cultivated in France, Spain and Italy. For this oil of the fruit, 
which is obtained by expression, the tree is cultivated. Virgin 
oil is obtained from the fruit before it is thoroughly ripe, and is 
considered better than that which is expressed from the mature 
olive fruit. 



.\NI> THERAPEUTICS. 



137 



Fig. 14. 



Olive oil, sometimes called sweet oil, is an unctions liquid of 
greenish-yellow color, and sweetish, not unpleasant taste. It is 
a soothing, unirritating oil, and used to lubricate instruments in- 
tended to be brought in contact with sensitive parts, as well as 
for the general soothing and 
protecting purposes of demul- 
cents. It is also an aperient, 
and referred to again in that 
class of remedies. 

Bismuthi Sttbnitras— Suhni- 
trate of Bismuth. 

This salt of bismuth is a 
white, inodorous, almost taste- 
less powder. Its physiological 
action is not very satisfactorily 
determined by the profession, 
and hence the modus operandi 
in giving relief from certain 
irritable and painful conditions 
of the stomach and bowels is 
not definitely settled. It has 
been considered a mechanical 

agent only, by which the tender mucous membrane is coated 
over, soothed and protected, after it has been deposited on the 
surface so as to form a pasty coating. Some writers have con- 
ceived the idea of a kind of local alterative effect not well un- 
derstood; others, that the only direct influence exerted is its 
absorption of accumulated fluids, and thus it tends to lessen the 
frequency of diarrhoeal discharges. The first of these theories 
seems most plausible, and is that upon which it has been given a 
place in the class of demulcents. Bismuth evidently is compara- 
tively inert, so far as any very active local or elective medicinal 
properties are concerned ; for very large doses are frequently ad- 
ministered to children much enfeebled by exhausting diarrhoea, 
without any violent impression. The dose, therefore, is not 
definite, ranging from five to thirty grains or more. It may be 




Olea Europcea. 
3, Fruit. 



138 A00L0G1 

given in the form of temporary suspension, by being stirred with 
water; and has been used with decided advantage in this form, 
by inject ion into t lie urethra and vagina, in irritable and inHamed 
condition of these parts. 

In addition to the demulcents already mentioned, as suitable 

for internal use, there are many other substances which have 
similar effects when applied to diseased parts externally. 

Oleum Lini — Linseed Oil — being unirritating, serves as pro- 
tection to the surface when denuded, and in some respects supe- 
rior to olive oil for this purpose. When from heat or other cause 
the cuticle is removed from a considerable portion of the surface, 
linseed oil is a favorite application, with some practitioners, either 
alone, or with cotton or flour. 

Collodion, and the solutions of Shellac, Grutta Perclia, and all 
protecting cerates applied to ulcers, and injuries of any kind, 
afford a permanent and impervious protection to such parts, and, 
not having irritating qualities, are useful for this purpose, as 
demulcents. 

CLASS II. 

EMOLLIENTS. 

Tins class is comprised of such preparations as soften and re- 
lax the surface when applied to it, known as poultices. Sub- 
stances containing warmth and moisture produce these effects, 
and even moisture alone, with the acquired heat from the body, 
is usually sufficient for this purpose. 

A wet towel, folded and applied in the form of a compress, soon 
attains the temperature of the body, and affords the two ingredi- 
ents — heat and moisture — necessary to emollient effect. That 
article or mixture which retains moisture for the greatest length 
of time, is the most efficient emollient. Articles, therefore, should 
be selected with a view to this property. 

Emollients or poultices are used to soften and relax inflamed, 
swollen and painful parts, after cooling applications are no longer 
necessary. By this means relief is given from pain during the 
suppurative process, and the collection of pus allowed a better 
chance of making its way to the surface. 



\\|. THERAfcEtJTtCS. 139 

Poultices, used even in the active stage of inflammation, may 
often moderate its violence by their relaxing effect, notwithstanding 
the increase of temperature, which may occur when the applica- 
tion is continued without removal for some time. Until the 
poultice becomes dry, however, the evaporation from its upper 
surface is sufficient to prevent any very great increase of heat; so 
that by removing and wetting occasionally with cool water, the 
heat of the inflamed part, may not only fail to increase, but ac- 
tually subside to some extent. 

Emollients are used with great benefit in the treatment of 
wounds, ulcers, etc., when in an irritable and sensitive condition, 
with hemorrhagic tendency from slight touch. Also, when in- 
jured parts become dry, hot and painful, the application of a 
cool, soft poultice will renew the effusion of lymph, and hasten 
the suppurative process, or prompt adhesion. 

Great benefit is expected by some practitioners from poultices 
applied to the surface of the body for disease of internal organs, 
but beyond the relief afforded by relaxation of the skin, muscles 
and other tissues, forming the parieties, thereby lessening the 
pressure, perhaps no advantage is derived from them. When, 
however, the diseased part is situated in, or connected with, such 
superficial structure, the relaxing influence may affect directly 
the local inflammation, as in pleurisy, tonsilitis, etc. 

Catalogue of Emollients. 

Pulvis Ulmi, 
Lini Farina, 
Symphytum. 

Pulvis Ulmi — Pulverized Elm Bark. 

The bark of Slippery-Elm, which has been already noticed 
under the head of demulcents, is used, in the form of powder, 
extensively as an emollient. It answers equally well for ordinary 
purposes, whether coarsely or very finely powdered. When ap- 
plied directly to the surface, without intervening layer of cloth, 
the coarser powder, perhaps, is more conveniently used. 



140 ACOLOG1 

For inflammation of the eye, from injury or disease, slippery- 
elm affords the most appropriate poultice. In this case, it serves 
not only the ordinary purposes of the class, but protects the eye 
from light, and affords, in the dissolved gum, which exude- from 
the poultice, all the advantages of a demulcent applied to the in- 
flamed part. For this, and perhaps all other applications of the 
bark as an emollient, it may be prepared in the following manner: 

A little sack made of soft, old linen, should be one-fourth 
rilled with the pulverized bark, well stirred with water to 
a semi-fluid consistence, and applied to the inflamed part. It 
should afterwards be dipped occasionally in cool water, as it be- 
comes warm and unpleasant. By this mode of preparing the 
poultice much inconvenience may be avoided, and greater efficacy 
of the remedy secured. 

Lixi Farina — Flaxseed Meal 

The meal prepared from the seed of Linum Usifcdigrimwm, 
already noticed in the class of demulcents. Pulverized flaxseed 
is more generally used for ordinary poultices than, perhaps, 
any other substance. The mucilage made from the gummy ex- 
terior of the seed, described under the head of demulcents, gives 
to the powder when moistened, an unctuous consistence that 
adapts it well to the purposes for which articles of the class are 
used. In preparing a poultice from the flaxseed, they should be 
mixed with warm water in a proportion that will leave the mass 
sufficiently firm to maintain its form after being spread on cloth. 
The surface of the poultice should then be moistened before being 
applied, and afterwards, as often as may be necessary, to keep the 
part on which it is placed perfectly moist. When intended for a 
raw and sensitive part, a piece of gauze should intervene so as to 
prevent coarse particles of the meal from contact with it. This 
also prevents portions of the poultice from adhering, and thereby 
facilitates the removal and reapplication when necessary. 

Symphytum — Comfrey Root. 

The root of Symphytum officinale, mentioned as a demulcent, 
serves also the purpose of an emollient. The cultivation of this 



AND THERAPEUTICS. 141 

plant being so general in gardens for private families, there is 
little difficulty in readily obtaining the fresh root when required. 
In preparing a poultice, the root should be bruised and rubbed 
up with warm water to the proper consistence. This, when 
properly prepared, makes a suitable emollient for cases in which 
such applications are necessary; its mucilaginous character ren- 
dering it soft and unirritating even to sensitive parts. 

Warm water, or even cold water, applied so as to prevent 
evaporation, and to assume and retain the temperature of the 
body, will answer, in some cases, all the purposes of an ordinary 
poultice, according to the acknowledged modus operandi of the 
class. Warmth and moisture, as already stated, are said to be 
the essential qualities of emollients for ordinary purposes, and 
whatever, therefore, possesses these, and is not irritating, or 
otherwise injurious, constitutes a poultice. 

Soft cloth, folded into several layers, dipped in warm water 
and applied to the body, affords the essential properties, when 
confined to the part by a thick, dry bandage or covering. One 
article is preferred above another only for its bland, soothing 
qualities, and greater capability of retaining moisture. For very 
irritable and sensitive parts, mucilaginous substances, such as 
slippery-elm, etc., are preferable, on account of their demulcent 
effect upon the raw surface. When applied to sound parts 
however, this quality is not so essential, and may be dispensed 
with. By means of folded cloth, wet with warm water, a very 
extensive poultice may be readily applied. In this way, the sur- 
face of the whole trunk may be softened and relaxed, modifying 
to some extent, the cutaneous circulation. 

This process is empirically practiced extensively under the 
one-idea system of hydropathy, and is called "the pack." 

CLASS III. 

MECHANICAL COUNTER-IRRITANTS AND LOCAL DEPLETIVES. 

Local depleting measures produce more or less counter-irrita- 
tion, and are sometimes used for both effects. By the more active 
and enduring means a drain is established, which eventually 



1 \-2 LC0L0G1 

brines about results similar to the local abstraction of I»I<m><1, ><> 

■ 

far as regards the relief to internal organs, in a -latent' engorge- 
ment. Leeches, cups and scarification are oftea made to precede 
these mean-, in Long-standing chronic affections, and are used 

alone in less permanent local disease, when eonnter-irritation and 
depletion arc required for a shoii time only. 

Catalogue of Mechanical Counter-Irritants and 
Local Depletives. 

Hirudo, Setaceum, 

Cucurbitula, Fonticulus, 

Acupuncture, Moxiburium. 

H i R u do — Th e Leech . 

This aquatic animal, hirudo decora, is three or four inches in 
length, of dark-greenish color, and has a round suction disk at 
each extremity, in the anterior of which the mouth is situated; 
having jaws armed with several sharp teeth. By this arrange- 
ment the skin is punctured and suction made, so as to abstract 
blood from the part on which the leech is applied. The Euro- 
pean leech, hirudo medicinal is, does not differ very materially 
from the American variety above described. It is believed, 
however, that the former attach themselves more readily, abstract 
more blood, and are, therefore, preferable. It is estimated that a 
large leech will draw half a fluidounce of blood, and perhaps as 
much more will exude after it drops off. 

Leeches can be applied advantageously to various parts, in a 
state of local engorgement or inflammation, which will not admit 
of cupping; and, as a means of local depletion in children, is prefer- 
able to cups and scarification, even when the latter can be effected 
without difficulty. Leeching had almost gone into disuse, in 
many parts of this country, until advancement in the pathology 
and treatment of uterine affections made it necessary to renew 
the practice. It has been ascertained that much suffering is pre- 
vented by the timely use of a few leeches, in that engorged con- 
dition of the uterus which leads to the development of various 



AND THERAPEUTICS. 143 

uterine lesions. Chronic metritis, endo-metritis, ulceration and 
their complicated ever-harassing results — prolapsus, leucorrhoea, 
and the innumerable pains and aches from reflex disturbance of 
the nervous system — often commence in simple engorgement. 
Even when chronic inflammation has been established, and en- 
gorgement with increased weight of the organ has passed away, 
the duration is very decidedly shortened by premising the treat- 
ment with the use of two or three leeches. This number will 
generally affect all the depletion necessary at one time; and a 
cylindrical glass speculum introduced in the vagina, including 
the os uteri in its extremity, affords convenient means of apply- 
ing them. The os should be well cleansed with a moist sponge, 
and if the leeches fail to take hold, slight scarification, so as to 
discharge a drop or two of blood, generally induces them to draw. 

Leeches also afford the best means of depletion in hemorrhoidal 
tumors, furuncle, carbuncle, orchitis, etc. A leech applied to an 
incipient boil will be likely to abort it completely. In this way 
local depletion can be had with less pain and injury to the struc- 
ture than by any other mode. 

The hemorrhage from leech -bites sometimes, though rarely, is 
troublesome, continuing after the desired amount of blood has 
been abstracted. Pressure w r ith the finger, or a compress upon 
the orific for a few moments, will generally arrest the flow when 
it is desirable to do so. When, however, from the loss of plasma 
in the blood or tone in the tissues, the bleeding obstinately con- 
tinues, a pledget of lint saturated with a solution of perchloride of 
iron, or the application of lunar caustic, may become necessary. 

Cucurb i tula — Cupping Glass. 

Cupping may be practiced with or without scarification. 
Counter-irritation, to the extent of rubefacient action, may be had 
by dry cupping ; but when local depletion is also desirable, the 
part should be scarified before the cup is applied. Blood is thus 
forced to the surface and abstracted, by partial exhaustion of the 
cup and the consequent suction induced. 

The most convenient cupping glass is that attached to a hollow 
rubber bulb, which being exhausted by pressure of the hand, the 



Ill ACOLOGY 

cup will firmly adhere to the skin, when pressure cease-, the 
elasticity of the rubber producing a sufficient amount of suction. 
This form of cup has superceded the more inconvenient mode of 
exhausting by a pump attached, or bya Lighted taper to consume 
the oxygen. 

Scarification is generally performed with an instrument for the 
purpose, called scarificator; but the incisions may he made with 
a bistoury, razor or lancet, in absence of this instrument. Cups 
may be readily applied along the spinal column, to the chest, 
temples and abdomen. The spinal cord, when the subject of 
irritability from direct or reflex impressions, may he relieved by 
this means. In chronic uterine disease, cups to the sacrum not 
only counteract reflex irritation of the cord, but act favorably 
upon the engorgement and irritation of the womb itself. 

Periodical cephalalgia, or sun pain, and cranial or facial neu- 
ralgia are sometimes relieved by cups applied to the temples; and 
ophthalmia yields readily to treatment after cupping in the tem- 
ples, which otherwise proves intractable. 

Like many other valuable remedies, cupping fails of success 
often from being improperly performed. In order to be effectual, 
in certain cases, the abstraction of a certain amount of blood is 
necessary. The cups fail to fill, sometimes, on account of press- 
ing so firmly against the cranium, that blood does not enter the 
part upon which suction is made; and by slightly raising that 
side of the cup which presses on the artery supplying this portion 
of the scalp, the blood at once flows freely. 

This operation can, sometimes, be made to answer all the pur- 
poses of counter-irritation, general and local depletion, in menin- 
gitis and other local inflammatory diseases, particularly in young 
subjects. 

Acupunctura — Acupuncture. 

This process consists in piercing the skin with needles, and has 
long been known as a remedial means. The punctures may be 
made by a single needle, or an arrangement by which several are 
thrust into the skin at the same time. 

Puncturing with needles has been had for other effects than 



\Nl> THERAPEUTICS. 145 

that of counter-irritation. Nsevi materni, and other varicose tu- 
mor.-, are relieved by piercing them with needles, thereby excit- 
ing inflammation and consequent adhesions, which break up the 
unnatural circulation of the part. Surgeons resort to acupuncture 
for this purpose, but in this case the needle is thrust through the 
tumor instead of merely pricking the skin, as in counter-irrita- 
tion. The irritation produced in the skin by needles is greater 
and more durable than that by ordinary rubefacients, but less so 
than the action of vesicants. The operation is not attended with 
excessive pain, and produces an impression which remains for a 
day or two. 

An instrument, perhaps of German invention, is in use for 
acupuncture, called Lebens-weeker. It is so constructed, that, 
by a spring, some dozen or two of needles are made to pierce the 
skin, in the space of an inch in diameter, and being thickly 
clustered together, they do not pass through the skin, even when 
applied with considerable force. Acupuncture over the spinal 
column when in an irritable condition, and along the course of 
nerves, which are the subject of painful disease, may be usefully 
employed, if repeated every two or three days, and kept up for 
some weeks. 

Setaceum — Seton . 

The most certain and permanent counter-irritation is that pro- 
duced by the seton. Being purely mechanical, its action may be 
kept up from the same operation for any desired length of time, 
and without excessive pain or unnecessary destruction of tissue. 
Slight hemorrhage from the wound made by the introduction, 
though generally inconsiderable, may sometimes amount to local 
depletion, but suppuration, which is soon established, affords a 
constant drain from the part, and answers the same purpose, to 
some extent. 

Setons, like other counter-irritants, are applied to that part of 

the surface opposite or near the affected organ ; as, for instance, 

on the chest in bronchial, pneumonic or pleuritic disease; and 

back of the neck, or on the temple for affections of the eyes and 

10 



l 16 AOOLOG 

< 'a i->. Diseases of a chronic nature alone are subjecl t<> benefit from 
this remedy, for, in acute affections, the reason for its use will 
have ceased before the lull effect can be established. Silk, cotton, 
flax, or any substance which keeps up irritation, introduced into 
or under the skin, forms a seton. Through a fold of skin, held 

between the fingers, a seton needle, armed with thread, a pit 

ribbon or slip of cloth, may be carried, leaving the seton in the track 
of the needle. An eyed probe, carrying a piece of ribbon, may be 
passed through an opening made by a lancet, and answers the 
same purpose. From the presence of this foreign substance sup- 
puration is soon established in the sub-cutaneous celluar tissue, 
which is increased by occasionally drawing a fresh portion of* the 
seton into the sore. 

The seton is used in a surgical operation, having for its object 
the relief of false joint, from ununited fracture. For this pur- 
pose thread or other foreign substance is passed between the frac- 
tured ends of the bone, and is intended to excite the deposit of 
callus, an object entirely different from that under consideration. 

Fontk !ULUS — Issue Pea. 

On the same principle upon which the seton acts, the issue 
pea also produces counter-irritation, and establishes a local drain. 

A bean, pea, pledget of lint, or other solid substance, inserted 
within or under the skin, forms the issue in question. While the 
local irritation and issue formed in this way may be found use- 
ful, it has been almost entirely superseded by the more conveni- 
ent mode of producing these effects by the seton. 

Jfoxiburium — Moxa — and other escharotics used for their 
counter-irritant effect, produce general results on local disease, 
similar to those of the seton, but with less regularity and per- 
manency of action. They are considered, in the division of rem- 
edies affecting adventitious substances and structures, under the 
head of escharotics through chemical process. 

Friction and Dry-cupping, mentioned as rubefacients, belong- 
properly to the class of mechanical counter-irritants, but having 
only the effect of slightly reddening the skin temporarily, are 
not entitled to a prominent notice here. 



PART III 



ORDER II. 

ELECTIVE REMEDIES. 

SUB-ORDER I 

ELECTIVE ACTION THROUGH CHEMICAL PROCESS. 



DIVISION I. 

REMEDIES THAT AFFECT THE BLOOD. 



This division is dispensed with by some writers on Thera- 
peutics, and the remedies properly belonging to it are considered 
under the various heads of " Alteratives/' " Tonics/' <fec. The 
arrangement of this work is intended to group, in a division, all 
of the remedies, and those only, that act directly upon the same 
part, whether that part be diseased or not ; and hence the divis- 
ion under consideration. It must not be inferred from the recog- 
nition of a group of medicinal agents, acting directly upon the 
mass of circulating fluid, that the various and unreasonable theo- 
ries of blood diseases are sanctioned. The classes which are 
made of these divisions clearly show, that the blood, in a normal 
state, is acted on to affect diseased structures, as well as to afford 
deficient ingredients, and rid it of injurious substances. Like 
other divisions, this affords classes of remedies which act on 
healthy parts, to effect changes in diseased organs, and it will be 
found that some of the classes in this division lessen, while others 
increase the quantity of healthy blood, in order to relieve dis- 
ease in solid structures. 



I 18 AC0L0G1 

CLASS I. 

II .K M A T [NICfi 

As the Dame implies, the remedies of this class affect the blood 
directly, so as to increase the hsematin, or red corpuscles. In 

proportion to the amount of these, the blood is supposed to he 
nutritious and invigorating to the body ; or, at any rate, more 
capable of receiving and containing nutrient principles. 

It is not always necessary to use other means than nourishing 
food, when impoverished condition of the blood exists ; lor this 
is often sufficient to restore the essential lost ingredients. When, 
from the effects of disease, or other cause, the blood loses these, 
full diet of nourishing food is generally the best haematinic. 
Sometimes, however, the blood becomes so utterly impoverished 
that the organs of innervation, digestion and assimilation are not 
sufficiently nourished to perform their functions properly, and, 
consequently, the food intended to furnish material for it, cannot 
be prepared and appropriated. Diseases of these organs also in- 
terfere with the process of preparation necessary for the food t<> 
pass through, in order to replenish the blood. Under such cir- 
cumstances, the medicinal agent, or other means which will af- 
ford the blood such required ingredients without the process of 
digestion, etc., may be introduced into the circulation directly, by 
absorption from the alimentary canal. 

Catalogue of JLematinics. 

Cibus, Oleum Morrhure, 

Ferritin, Transfusio. 

Cibus — Food. 

This natural means of furnishing all the essential ingredients 
of the blood, is also considered under the head of gastric or di- 
gestive tonics. In that connection, solid and fluid, irritating and 
unirritating articles of food are properly considered with reference 
to derangement of the stomach, but in this place it is proper to 
notice it as a haematinic or blood-maker, in regard, particularly, 
to its capability of furnishing necessary ingredients for a healthy 



AND THERAPEUTICS 145) 

or natural condition of the blood itself. When this fluid is im- 
poverished, and the organs which prepare food for haematosis or 
blood-making, properly perform their functions, oily and album- 
inous substances, such as butter, eggs, meat, milk, etc., form ap- 
propriate hsematinics. These, with such articles as afford water, 
salts and sugar, give to the blood the elements necessary to afford 
material for every tissue of the body. The selection must be 
made according to the deficiency which may exist in the blood, 
the necessity or desire that may be felt for particular ingredi- 
ents. When, from loss of blood by hemorrhage, or when failure 
on the part of the digestive organs to replenish, the proportion of 
watery ingredients greatly increases. Absorption is rapid under 
these circumstances, from the ease with which the absorbents 
discharge their contents into the depleted blood vessels. In this 
case the blood, though sufficient in quantity, becomes thin, pale, 
innutritious, and requires an increase of the red corpuscles and 
plastic material. 

Flour of meat, as advised by Dr. Hassal, of London, is pref- 
erable to any other preparation, on account of its containing all 
the nourishing ingredients of which meat is posseesed. The 
extracts prepared by Liebig, Bellat, Martin de Lignac, and 
others, are deprived of the most important nutrient and calorific 
elements for which meat is useful. Albumen, fibrin and fat are 
not found in the various extracts, juices and teas of beef, about 
which so much has been said in praise, and as these principles 
are essential in giving that vigor necessary to raise the ca- 
chectic and strumous constitution above the scrofulous and 
tuberculous development, we can see no good reason for prefer- 
ring preparations in which none of these useful ingredients are 
preserved. 

Flour of meat is prepared by drying the meat at a low heat, 
so as to deprive it of all the water, and then grinding to a ver} 
fine powder. In this form it is preserved for any desirable 
length of time, and may be used for making soup, beef tea, 
meat biscuit, or any other form of meat diet. This is suited 
particularly to children and aged persons not supplied with 
effective teeth. One pound of the Hour of meat is equal to 
about five pounds of ordinary meat (U. S. D.) 



150 A< ni.ncv 

FeRRTTM — Iron. 

Iron is, by all, considered a tonic. Some sj x-n k of it a> n 
tonic to the blood, some to the nervous system, while others use 

and recommend it as a tonic to the digestive organs. In one 
thing all agree: that it is an invigorator, and in this are doubtless 

correct. A mistaken view as to the cause of debility may not 
only lead to error in therapeutics, hut in explaining the modus 
operandi of remedies, empirically or accidentally given, and 

found useful in its treatment. If, from imperfection in the di- 
gestive organs, anaemia and debility result, and iron alone he ad- 
ministered tor their relief, in all probability the practitioner will 
not realize the desired permanent benefit. Again, if these symp- 
toms exist in consequence of a deficiency, from any cause, of prin- 
ciples in the blood, which iron supplies, they may permanently 
give way under its use, though it be prescribed with the erroneous 
view of correcting deranged functions of the stomach or the ner- 
vous centres. If the physician concludes that inactivity of the 
latter organ exists as the cause, the remedy is set down as a ner- 
vous tonic; if the former, he insists upon its tonic power on the 
digestive organs. In this way, perhaps, many erroneous proper- 
ties are ascribed to remedies. 

While it is not at all certain, iron may possibly have some 
direct tonic influence over the nervous system. The fact of ner- 
vous debility being relieved by it is not, however, evidence of its 
truth. The nervous centres may fail to afford the necessary 
amount of influence, owing to deficiency in the invigorating in- 
gredients of the blood. If this deficiency be restored to the 
blood by iron, a careless observer would very readily conclude 
that the direct action was exerted upon the brain and spinal 
marrow. The blood is evidently affected directly by the prepa- 
rations of iron. When the watery constituents of this fluid arc 
excessive from any cause, manifested by paleness of the skin, 
general debility, hemorrhage, or dropsical tendencies, iron, 
which it is supposed increases the red corpuscles, and thereby 
lavs the foundation for increase of plasma, improves the quality 
of this fluid, and relieves these symptoms. It is, therefore, pre- 



AND THERAPEUTICS. I6l 

scribed with confidence of benefit, in eon junction with other ap- 
propriate remedies, in dropsical effusions, anaemia in cachetic or 
chlorotic subjects, purpura hemorrhagica, etc. 

Uncombined iron is insoluble, and even in the forms of oxide 
and carbonate, only partially so, in water. When taken in any 
of the forms which are insoluble in water, the remedy is depend- 
ent, for its absorption and activity, upon the acid with which it 
meets in the stomach. When in fine particles, the metal readily 
oxidizes, and in this state is easily converted into soluble salts by 
the acids met with. 

Ferri Subcarbonas — Siibcarbonate of Iron. This is a brown- 
ish-yellow powder, inodorous, of earthy taste and insoluble in 
water. 

The preparation is generally supposed to possess nervous tonic 
properties, and is usually selected when the remedy is given for 
inactivity of the nervous system. Why it should be more effi- 
cient than the more soluble preparations, is not very clear, yet 
even for its direct effect upon the blood, the carbonate is often 
prescribed. It is given in hysterical nervous derangement, and 
probably with advantage in chlorosis, and other forms of anaemia, 
dependent upon functional organic derangement of the uterus, 
but in this state of the organ, its effects are temporary. It is 
also frequently given with quinine in chronic intermittent fever, 
after the system is worn down and the blood impoverished 
by long-standing disease. The dose is five grains, three times 
a day, in the form of pills, or made into an electuary with honey 
or syrup. 

Ferrum Redactmn — Reduced Iron — Iron by Hydrogen. This 
preparation is said to consist of metallic uncombined iron in the 
state of very fine powder, and is obtained from the carbonate by 
passing hydrogen over it in a heated tube. It is of grayish color, 
inodorous, tasteless, and insoluble in water. Powder of iron, 
fifteen years ago, was the most popular of all the preparations. 
This, like other sensations, has had its run, passed away, and 
now the preparation ranks as others, which are soluble only by 
contact with acid in the stomach. It may be used for the ordi- 
nary purposes for which iron is found beneficial, and in the same 
dose and form of administration as the carbonate. 



152 ACOLOGl 

i'liri CUros — Citrate of Iron — is in the form of thin reddish 
scales, voluble m irate,-, and lias chalybeate taste. It has all the 
good effects of the less soluble preparations of iron, and at the 
same time much more certain of being speedily absorbed into the 
circulation. In the form of solution it may be administered, bu1 
to conceal the taste, pills are made of it, with some adhesive sub- 
stance suitable for the purpose. The dose is five grains three 
times a day. On account of its solubility and mildness of act ion, 
the citrate is one of the most useful preparations of iron, to affect 
the blood. 

Ferri Sulphas — Sulphate of Iron — Green Vitriol. The com- 
mercial salt, known as copperas, is not sufficiently pure for me- 
dicinal purposes, having other metals combined with it. Pure 
sulphate of iron is in crystals of a greenish color, astringent, 
somewhat styptic taste, soluble in water, and readily efflorescent 
when exposed to the air, falling into a whitish powder. 

The astringent property possessed by this salt interferes with 
its use, to the extent desirable in some cases, while in others it is 
thereby rendered more efficient. In relaxation, chronic inflam- 
mation or ulceration of the alimentary mucous membrane, and 
hemorrhagic tendency, this property makes it a decidedly useful 
local remedy, while the blood receives, at least, some of its in- 
vigorating qualities through absorption. On the other hand, 
when it is necessary to use ferruginous preparations for a long 
time, and the alimentary canal be not in a conditition to bear 
well so active astringent, the preparation is objectionable as a 
ha3matinic. In overdoses, and even in quantity only sufficient to 
relieve anaemic conditions, irritation of the mucous membrane 
may be produced, and it is, therefore, less used in ordinary cases 
of impoverished blood than milder preparations. 

Sulphate of iron is given in the dose of tiro (/rains, made into 
pills or dissolved in water. The former is preferable on account 
of the unpleasant taste of the salt in solution. 

This article is supposed to act as a tonic upon the stomach, and 
it may prove to be such, on account of its astringent property, in 
cases where indigestion exists in consequence of a relaxed or 
otherwise unhealthy condition of the mucous surface, requiring 
this local action. 



And therapeutics, 153 

Oleum Morbhtlss — Ood-IAver Oil. 

Oil obtained from the liver of Gadus Jforrhua, or eodfish, and 

other speeies of Gadus. 

The best oil is obtained from the fresh liver, by a heat below 
the boiling point of water. While gadus inorrhua affords most 
of the commercial oil, that from other species of the codfish is 
also found in market. The great demand for it leads to the sale 
of adulterated and spurious specimens; and, unfortunately, there 
is no certain test by which its purity may be known. As com- 
mon train-oil or lamp oil is, perhaps, more frequently substituted 
for the genuine article, a familiarity with the sensible properties 
of this, is the best means of guarding against imposition. 

Cod-liver oil is supposed to be superior to any other -fatty 
substances, in giving to the blood those qualities by which the 
greatest amount of healthy nutrition and vigor are given the 
tissues. There is no doubt that an impoverished condition of the 
blood, and general deficiency of heat and vigor in strumous 
constitutions, lead to the deposit of scrofulous and tuberculous 
matter, and that oleaginous food and medication tend greatly to 
increase the heat of the body and to replace those ingredients of 
the blood, which are necessary to the arrest of this morbid pro- 
cess. Oily food is, therefore, considered prophylactic against the 
development of tuberculosis or scrofula, in persons of strumous 
diathesis. 

The disgust felt by most persons for cod-liver oil, interferes, 
however, with its use in this way, and it is doubtful whether any 
advantage is afforded above those had by fit meats, butter, milk 
and cheese, for this purpose. Indeed, the stomach often fails to 
digest, and even sometimes rejects the oil; and in such cases reliance 
must be had in the less offensive and more easily digested articles 
of diet mentioned. This course is the more reasonable since 
such food affords not only a considerable amount of oil, but the 
elements necessary to support the muscular and fibrous struc- 
tures. All things considered, it is likely that more good may 
be effected in an impoverished condition of the blood from any 
cause, and even depraved constitutional tendency, by enjoining 



1-) [ m oLocii 

liberal diet alone, than the regular use of lull doses of cod-liver 
oil, to the neglect of oily and albuminous food. 

Cod-liver oil may be taken three times a day in the dost of <t 
tablespoonful or more. Many modes of preparation to conceal 
the taste have Keen suggested, such as jelly, etc. Perhaps the 
best plan, however, is, as with castor oil, to destroy the sensibility 
of the mouth with some pungent substance, such as tincture of 
cloves or giuger, take the oil alone, and then again a small 
quantity of the tincture. 

Tra nsfusio — Transfusion. 

As early as the seventeenth century, the transfusion of blood 

from one living being to another was practiced. Even before the 
day of those who have left a detailed account of their practice in 
this way, the process seems to have been known. A quarter of 
a century since, great excitement prevailed in France on this 
subject, not only amongst medical men but in other circles, on 
account of experiments made on human subjects. The result of 
scientific investigations, made at this time by Dumas and others, 
proves that life may be preserved, after excessive hemorrhage, by 
supplying blood from another animal of the same species, and 
that transfusion may be made useful in the treatment of many 
diseases. 

Different modes were adopted. The transfer of blood directly 
through a tube, from the vein or artery, to the vein of another, 
and the pumping of blood into the vein from a vessel in which 
it is being received from a healthy man, are the principal plans 
that have been adopted. The former gives less risk of introduc- 
ing coagula and air, which, of course, may lead to serious conse- 
quences ; the latter has the advantage of determining the exact 
amount transfused. An instrument by which the blood is con- 
veyed into a receptacle, and thence pumped into the vien, has 
been invented. By preserving the proper temperature of the 
instrument and not allowing the blood to remain any length of 
time in the receptacle, the danger from coagula may be avoided ; 
and by pumping until the air is all discharged and a jet of blood, 
without bubbles, escapes from the tube, before introducing it into 



AND THERAPEUTICS. 1&5 

the vein to be supplied, air may be prevented from entering the 
cin 'illation. 

Various exhausting diseases, such as cholera, typhoid fever, etc. 
have been treated by transfusion, and it is not unlikely that much 
benefit may be derived from this manner of applying, directly, 
pure and nourishing blood in many cases where the food cannot, 
in time, if at all, be properly prepared by the digestive organs 
to replenish the wasted circulation. The results of recent experi- 
ments favor the opinion entertained by former investigators on 
this subject j and there is no doubt that enough is known of its 
effects to guide the profession safely through the difficulties that 
may attend this highly important mode of treatment. 

Six to eight ounces of blood from a healthy person, properly 
conveyed into the veins of one in whom the vital current is al- 
most exhausted, is considered a sufficient quantity, and will 
doubtless allow 7 time and other advantages in the treatment of 
affections, otherwise necessarily fatal. 

This process may be useful,, not only in cases of excessive 
hemorrhage and acute prostrating and exhaustiug disease, but 
for the support jf anaemic subjects of any kind, and may be re- 
peated from time to time as may be found necessary. 

Transfusion is destined again to be revived. The subject is 
being agitated in Europe and America by occasional practical 
allusions. Recently, Dr. Aveling, of London, has published in 
the " Lancet" the report of a ease with great prostration from 
loss of blood, treated successfully by his plan. The mode em- 
ployed was that of direct transmission of blood from the blood- 
vessel of a healthy subject into that of the patient. A tube is 
inserted into the vein of each, being connected by intervening 
elastic tubing with a bulb in the centre and a stop-cock at each 
end. The tube being filled with water, the affluent stop-cock is 
opened, the effluent closed, and the water forced into the patient's 
vein by compressing the bulb. Then the effluent stop-cock is 
opened and the other closed, so that the expansion of the bulb 
draws blood from the subject, which is forced into the patient's 
vein, as at first with the water. In this way, the coagulation of 
blood, and the entrance of air may be prevented. The water with 



156 ACOLOGl 

which the whole tube, including the l>ull>, is at firs! filled, can- 
not, if of a proper temperature, do injury to the patient, and gives 
place in the tube to blood, which, by prompt action on the pari 
of the operator, is not at rest sufficiently long to favor coagulation. 

CLASS II. 

S1WN.KM1CS 

THIS class includes all the mean- used to render the Mood less 
exciting and nutritious. 

Spansemics — from <77ravoc, poor, and ac/ia, blood — are used, 
sometimes, with objects similar to those had in the admin- 
istration of cardiac sedatives; in fact, some of the same means 
have a place in both classes. In the treatment of inflammatory 
disease, it is found necessary to reduce the heart's action, in order 
to moderate the force of the circulation in the diseased part, and 
also to destroy the exciting quality of the blood. 

Blood-letting answers both purposes. By it a portion of the 
heart's stimulus is withdrawn; and though the absolute amount 
of the circulating fluid may soon be restored by absorption of 
watery ingredient, the proportion of nutrient principles, is, to 
that extent, lessened, and not only the heart, but the inflamed 
tissue is less excited by the blood. 

Moreover, when the circulating fluid is rich with fibrin, albu- 
men and red corpuscles, the circulation is sluggish in the capilla- 
ries, and, thereby, existing engorgement and inflammation is 
likely to be increased. From this cause, the brain, when there 
exists an apopletic tendency, is subject to injurious pressure, on 
account of effusion, or distension of the blood vessels. 

Spanseinics of every kind lessen the relative proportion of rich 
material in the blood, and thus fill the indications in the condi- 
tions above 1 named. Therefore, in adynamic diseases, they are, 
of course, injurious, and should not be used. As seen in the 
class of catalytics, certain articles destroy fibrin, one of the 
nourishing; ingredients of the blood; and by this catalytic action 
they, to this extent, become also spansemics. Some of these, by 
long use, destroy invigorating principles in the blood, and hence 



AND THERAPEUTICS. 157 

are objectionable in certain diseases in which otherwise their 
catalytic action upon certian morbific agents would render 
them useful. Thus mercury, by its spansetnic or impoverishing 
effect upon the blood, in the catalytic action upon fibrin, renders 
it injurious in scrofula, though it should aid in the solution and 
elimination of morbific material; because impoverishing of blood 
favors the increase of such material in it. This spansemic 
effect of mercury makes it injurious in tuberculosis, adynamic 
fevers, etc. Its preparations, dose, etc., sufficiently dwelt upon 
in other diseases, needs no further notice. 

Low diet, not containing the elements of rich blood, leads to 
span semi a, and is, therefore, one of the means of impoverishing 
this fluid. The qualities and preparation of food, described in 
the class of gastric or digestive tonics, needs no further notice 
now. Suffice it to say, therefore, that food and drinks containing 
the smallest amount of albumen, fibrin and fatty matter should 
be selected. 

CLASS III. 

DILUENTS. 

This class is composed of such drinks as are readily absorbed 
by the veins and dilute the blood. The proportion of watery 
constituents is increased, as in the action of spanremics. When 
diluent drinks are taken without depletion, the absolute amount 
of circulating fluid is increased, but by catalysis, blood-letting, 
etc., the quantity is lessened to that extent, and absorption, which 
is thereby increased, supplies the deficiency with diluent fluids. 
It will thus be perceived that dilution is the result of depletion 
and the action of other span&emics, as well as the use of copious 
draughts of Avatery liquids. The last of these only come properly 
under the head of diluents. 

Cool water is the natural diluent of the blood. The economy 
is so constituted that thirst, the desire for drink, exists when heat, 
excess of salts or deficiency of serum prevails. In febrile affec- 
tions, the use of this beverage leads to decrease of temperature, by 
affording material for cutaneous transpiration and evaporation 
upon the surface. 



158 ECOLOGY 

Certain liquids are more readily absolved than others, and arc, 
therefore, better diluents. Some <>(' them, when taken into the 
circulation, are more readily eliminated through the skin, others 
by the kidneys, and still others by the lungs and bowels. This 
difference consists in the different character of ingredients held 
in solution in the liquids. For example, a fluidrachra or two of 
the spirit of nitric ether, taken in a draught of water or simple 
tisan, tends to a copious flow of urine, while other substances are 
more readily eliminated by the skin, respiratory organs or bowels. 

Cold or warm Infusions or decoctions of simple substances, 
called Teas, act merely as diluents; some of which, from their 
tendency to elimination by the skin, are called " diaphoretics." 

( 'hamoviili , sage, eupaJtoi'ivmi and balm infusionSy and saccharin* 
and acidulated drinks are some of the simple diluents. By dis- 
solving in these, medicinal substances whose properties promote 
the activity of certain organs, or favor elimination through par- 
ticular emunctories, the various forms of fluid discharges maybe 
facilitated. 

Infusion of flaxseed, or watermelon seed and the juice, form use- 
ful diluent drinks in urinary diseases, in which the acrid urine 
irritates the inflamed passages. The dilution of the urine in the 
greatly increased quantity, caused by the use of these drinks, 
destroys its irritating quality, and thereby allays suffering, and 
aids in the arrest of local inflammatory action in the urinary 
passages. 

CLASS IV. 

HAEMOSTATICS. 

This class of remedies, also called styptics, includes all the 
means used to arrest hemorrhage, whether proceeding from inter- 
nal vessels, to which they cannot be directly applied, or from 
those situated externally. While haemostatics proper, in the 
main, arrest the flow of blood by chemical changes wrought in 
that fluid, yet vital and mechanical measures are sometimes the 
most available means in this trying difficulty, and should not be 
overlooked in the study of remedial agents intended for its relief. 

The modes of mechanical procedure to be adopted by surgeon- 



AND THERAPEUTICS. 159 

and obstetricians to staunch sudden and violent hemorrhage, are 
more properly considered in works on these respective departments 
of science, and need not be included in a description of medicinal 
agents. There are, also, many astringents, whose vital action 
upon the soft tissues involved in hemorrhage, tend to arrest the 
discharge, that cannot, with propriety, be arranged in this class. 

Hemorrhage is, perhaps, always the result of abnormal condi- 
tion of the capillaries or larger bloodvessels from mechanical or 
vital cause, or of a changed condition of the circulating fluid 
itself. 

Hemorrhage occurring on account of a relaxed and feeble con- 
dition of the capillaries and tissues connected with them, from 
enervation or other cause; or on account of depraved condition 
of the blood, is called passive; otherwise it is called active. The 
difficulty must be met always, of course, by means suited to the 
various causes of disturbance. When the blood is impoverished 
and the serum greatly predominates, it more readily escapes from 
tissues through which it could not otherwise pass; and to prevent 
or arrest hemorrhage in this case, means, by which the proper 
chemical constituents of the blood are restored, and its coagula- 
bility promoted, become necessary. Direct styptics — those acting 
immediately upon the blood or tissues from which the hemor- 
rhage proceeds — are temporary only, and sometimes entirely in- 
effectual where the hemorrhage is dependent, as some suppose, on 
a want of nervous influence, as in petechia, a form of purpura 
or capillary hemorrhage from internal and external surfaces. 
Moreover, should the impoverishing or depleting mode of treat- 
ment, sometimes useful in active hemorrhage, be adopted, under 
the circumstances just mentioned, the hemorrhagic tendency will 
probably be increased. The same may be said of haematinic, or 
blood-restoring means, when applied to the active form, though 
useful in passive hemorrhage. 

Haemostasia — from acjua, blood, and azaal^, stoppage or stand- 
ing — as above intimated, is the result of chemical change in the 
blood itself, effected by the remedy, causing ready coagulation. 
Clots form after the blood escapes, preventing further hemorrhage, 
by mechanical interference. 



1G0 LC0L0G1 

Moreover, when the circulating fluid has been thus acted on 
by the haemostatic, and made more dense, it probably docs not so 
readilj pass through the tissues. 

Catalogue of Hemostatics. 

Plumbi Acetas, Acidum Carbolicum, 

Ferri Chloridum, Ferri Persulphas, 

Argenti Xitras. 

Plumbi Acetas — Acetate of Laid. 

This salt lias already been described under the head of astrin- 
gents, and is to be noticed now only in connection with its haem- 
ostatic or styptic effects. 

In hemorrhage proceeding from parts internally, and to which 
remedies cannot be directly applied, the acetate of lead is con- 
sidered an efficient haemostatic. To affect discharges in such lo- 
cations, the salt must necessarily enter the circulation in order to 
modify the blood or the structures connected with the bleeding 
vessels. Considerable importance is attached to the contracting 
power of astringents when applied directly to the mouths of 
bleeding vessels externally, and it is natural enough, without due 
consideration, to infer that by a similar modus operandi internal 
hemorrhage is also restrained. 

It is rather unreasonable to suppose, however, that when only 
two grains of the salt are distributed amongst the whole circu- 
lating mass, the remedy can reach the tissues, from which blood 
escapes, in a state of sufficient concentration to have any decidedly 
constringing effect upon them. A more rational explanation is 
that already given, making the arrest of hemorrhage attributable 
to a chemical modification of the blood, promoting its coagula- 
bility. And it may be true that most of the styptic influence 
exerted by this and other astringents, when applied directly to 
external hemorrhage, is due to this effect upon the blood itself. 
At any rate, the speedy formation of coagula, leaving a clot at 
the point of hemorrhage, certainly favors the suppression of 
further discharge. 



AND THERAPEUTICS. 161 

Acetate of lead is considered a valuable haemostatic in uterine 
hemorrhage, hsemoptisis and hematuria. It is usually given in 
connection with opium, and there is no doubt the desired result 
is rendered much more certain and decided by this valuable neu- 
rotic. Indeed, hemorrhage, dependent, directly or indirectly, 
upon the want of proper nervous energy, may be relieved by the 
preparations of opium alone. 

Sugar of lead may be given in the dose of two or three grains 
for this purpose, and repeated in an hour or two, if the desired 
effect is not produced. In cases, however, requiring such remedy 
for a longer period than a day or two, it should be substituted by 
some other haemostatic, lest the poisonous effects of the lead be 
brought on. 

Fekri Chloridtjm — Chloride of Iron. 

The chloride of iron, in the form of tincture, as noticed under 
the head of renal tonics, is identically the same combination of 
iron with chlorine, and in that form is often used as a styptic. 
"When chloride of iron is used internally, in hemorrhage, from 
depraved condition of the blood, the tincture is preferred ; and 
even for local application, it is, perhaps, equally serviceable. 
The solid chloride, or, as sometimes called, perchloride of iron, is 
in the form of small masses or fragments, having crystaline 
structure, yellow color and styptic taste. It is soluble in water, 
and may be used locally in a solution of any desired strength. 
Internally, the chloride of iron may be used in purpura hemor- 
rhagica, menorrhagia, hematuria, and all other varieties of hemor- 
rhagic tendency dependent upon a defibrinated and otherwise 
impoverished condition of the blood. In its action the density 
of this fluid is increased, by restoring essential ingredients, and 
also the tendency to coagulation of discharged blood promoted. 
For this purpose the tincture may be given in the dose of twenty 
drops, three times a day, well diluted with water. 

This preparation is used by surgeons in secondary hemorrhage 

from wounds or operations, with favorable results, when ligation 

proves unavailing. For this purpose lint, saturated with the 

tincture in full strength, or watery solution of the solid chloride, 

11 



162 ACOLOGI 

in the strength required, say eighty grains to the fluidounce of 
water, is applied in quantity sufficient to fill the wound leading 
to the bleeding vessel. In this way dots are formed in contact 
with the orifice from which the blood proceeds, and at the same 

time contraction of all the (issues connected with the wound 
occurs, leading to permanent arrest of the hemorrhage. 

Aneurysmal tumors are also obliterated, and serious hemorrhage 
prevented during the operation of artificially rupturing the 
tumor, by plugging up the opening with lint thus saturated with 
the tincture or watery solution. In order to he effectual as a 
styptic, in such cases, the remedy should be applied directly to 
the bleeding vessels, and the opening in the soft parts filled with 
cotton or lint, saturated with the solution. 

A (ID cm CARBOLICUM — Carbolic Acid. 

This remedy, which, during the last few years, has attracted 
considerable attention, now ranks high as a medicinal agent. It 
has been already mentioned in the class of catheretics. 

Applied locally in the strength of twenty to sixty grains to 
the fluidounce of water, it has been found to arrest hemorrhage 
from deep seated injuries very promptly. In order to this local 
action, cotton, saturated with the solution, should be forced into 
the wound, or pressed firmly to the bleeding surface. 

The general styptic effect of the remedy is that which gives it 
greatest importance. In monorrhagia, hematuria, etc., it affords 
the most certain and prompt relief. The author has seen pur- 
pura hemorrhagica, in which there was bleeding from the gums, 
tongue, kidneys and stomach, perfectly relieved in twenty-four 
hours by the internal use of this remedy. For these purposes it 
is given in the dose of tiro grains in three or four fluidounces of 
water, repeated in two to four hours. Menorrhagia is sometimes 
arrested by a single dose of the remedy. 

Besides these, and perhaps other prominent styptics that might 
be mentioned, the actual cautery, creasote, and the whole class 
of astringents, may be said to have haemostatic action. Some of 
these are often used topically for external hemorrhage. A solu- 



AND THERAPEUTICS. 163 

tion of sulphate of copper, applied as has been directed for chlo- 
ride of iron, may be used with benefit in many cases. 

The Hot Iron is sometimes applied in persistent hemorrhage, 
with prompt relief, when the bleeding vessel can be readily 
reached, so as to sear the open orifice and connected tissues. 

Creosote has a contracting effect from its peculiar exciting in- 
fluence, and may be used to advantage in hemorrhage from relaxed 
and inactive condition of the soft tissues. Capillary exudation 
may be arrested in this way, by direct application of the remedy. 

Nitrate of Silver may also be used profitably as a local styptic. 
We can bear testimony to the efficiency of this article in obsti- 
nate epistaxis. A case of nasal hemorrhage, which had resisted 
other astringent applications, and the tampon, until the patient 
was in eminent peril, yielded promptly to a solution of lunar 
caustic. 

Sub-sulphate of Iron, an unofficinal preparation, serves a val- 
uable purpose in rendering the blood coagulable, and contracting 
the tissues surrounding the orifice of bleeding vessels. There is 
no doubt that the arrest of hemorrhage, with this preparation of 
iron, is effected through these influences combined, and may be 
relied on as a local styptic in slight superficial hemorrhage. 

Styptic Colloid is a preparation of tannic acid with collodion, 
made by digesting the acid with alcohol for- ^ few days, then 
add ether till the mixture is quite fluid, and gun-cotton to satu- 
ration (Dr. Richardson.) This forms a styptic coating for hem- 
orrhagic abrasions, ulcers, wounds, etc. The ether and alcohol, 
evaporating, leave the gun-cotton and tannic acid in contact with 
the diseased or injured surface. Hemorrhage may thereby be 
prevented, while protection is afforded the denuded surface. 

CLASS V. 

CATALYTICS. 

It will be seen from the catalogue of Catalytics, that the arti- 
cles usually denominated "alteratives" or "eutrophics" stand 
prominently in this class. Eemedies that are found decidedly 
useful in effecting important changes, and whose action and modus 



164 kCOLOGI 

operandi are not well understood, making no visible impression 
at the time, have been called alteratives. For the reason that 
nothing was known of their direct action, the alteration or change 
in the general health and vigor of the system— »-the only visible 
effect — gave name to the class. 

A- the action of remedies become better understood, names, 
in accordance; with such discoveries, designating their direct 
effects, should be given the classes. "Eutrophics" is a term 
substituted for alteratives by Dr. Dunglison, which is expressive 
of the direct influence he supposed they exert in the improve- 
ment of nutrition. 

As their effects are now believed to be still more definitely 
understood, it is thought proper to call them catalytics, a name 
suggested by Dr. Headland, in his work on "The Action of 
Medicine." That author does not include under this head, most 
of the remedies known as alteratives or eutrophics, but the ac- 
tion he describes under the head of catalytics is evidently nearer 
that produced by these remedies, than any heretofore attributed 
to them. 

The name, catalytic — from tcaraXoat, to dissolve — implies the 
power to decompose, dissolve, eliminate or destroy. It is under- 
stood that the articles thus classed act upon the morbific agent 
by dissolving, decomposing or destroying it in some way. When 
placed in the group of remedies affecting the blood, the inference 
must be that the noxious material upon which they act is in this 
fluid, or intimately connected with it. Investigations, as to the 
nature of diseases relieved by this class, lead to the conclusion 
that, in some of them at least, certain substances are deposited 
from the circulation in various tissues and structures of the body, 
and that their existence and deposit constitute the leading feature 
in the pathology of those affections. The use of certain medi- 
cines is known to arrest further deposit, and the conclusion that 
these morbific agents are dissolved, decomposed or destroyed in 
some way, seems reasonable. It is not a great breach of pro- 
priety to group these as remedies affecting directly the blood, 
though they occasionally go further, and dissolve these substances 
in the alimentary canal, or other parts, before entering the circu- 



AND THERAPEUTICS. 165 

lation, or after being deposited by it in the solid tissues. Some 
of them, for instance, destroy fibrin in the blood, and also tend 
to decompose, and prepare for absorption, semi -organized fibrinous 
growths ; others tend to destroy or neutralize scrofulous or tuber- 
culous matter in the blood, and, it may be, prepare it for absorp- 
tion and elimination after being deposited in masses ; and still 
others, which neutralize acids in the blood, the urine, or in the 
alimentary canal, before it enters the circulation. 

It will be seen that the several articles of this class act on 
substances very different in their nature from each other. When 
more than one affects the same morbific substance, they do not 
necessarily destroy it in a similar manner. Some destroy the 
virus of syphilis; others the degenerate matter of scrofula, etc.; 
and the destruction may consist in solution and elimination, or 
in forming innoxious compounds. It is enough to maintain the 
plan of our classification, that all the classes of this division act 
upon substances in the blood, and that all the remedies of this 
class act in the same general manner in relieving the blood of 
the particular substance each article tends to destroy. It will 
be remembered that the system of classification adopted in this 
work is founded on the physiological, not the therapeutic action 
of remedies. It would, therefore, be improper, under this ar- 
rangement, to name the class of "digestive or gastric tonics" in 
accordance with the ultimate result in the improvement of nutri- 
tion; and equally so with remedies affecting directly substances 
in the blood, by which the same therapeutic effect upon the 
function of nutrition is obtained. Nutrition is disturbed by 
numerous breaks in the chain of normal functions, but it would 
be folly to classify the various means used to restore them, with 
reference to this ultimate result upon the nutrient function. 

Nutrition may be interfered with by paralysis of the nerves 
supplying a part, but the means instituted to restore the nervous 
energies could be named only with reference to the action had 
upon the diseased nervous system, even in a classification based 
on therapeutic action. Hence, the term eutrophics, which sig- 
nifies improvement of nutrition, could not be applied to them- 
With no less impropriety is the class under consideration named 



!()() ACOLOG 

eutrophios. In a physiological classification, even some of the 
means applicable in nervous disturbances just alluded t<>, could not 
be said to haveany direct effect upon the nerves themselves. Coun- 
ter-irritants and revulsives applied to, and directly affecting the 
exterior and internal surfaces for their therapeutic results upon 
the nervOUS centres, must, physiologically, be classed with refer- 
ence to their effects upon these surfaces. Hence, drastic cathar- 
tics, epispastics, etc., become indirect therapeutic nervous ex- 
citants, and lead ultimately to the restoration of the function of 
nutrition. 

. Catalogue of Catalytics. 

Hydrargyrum, Acidum Sulplmrosum, 

Iodinum, Chloroformum, 

Sarsaparilla, Ammonii Chloridum, 

Stilliugia, Chimaphila, 

Arsenicum, Antacida. 

Hydrargyrum — Mercury. 

Mercury, though a metal, is fluid at the ordinary temperature 
of the atmosphere. Indeed, it becomes solid only at a point far 
below zero of Fahrenheit's thermometer, and is used for this in- 
strument on account of the long range between the boiling and 
freezing points. 

As a medicine, it is said to be useless in the purely metallic 
state, and yet some of the preparations consist of the mineral, 
only in a state of very fine particles, in which it doubtless be- 
comes oxidized, however, before being administered. 

Mercury, which is mentioned under the heads of cathartics 
and anthelmintics, does not seem to require solution and absorp- 
tion to effect some of the objects for which it is used. It is sup- 
posed that while as a catalytic these processes are essential, yet 
catharsis and vermifuge action are possibly more perfect without 
absorption. Indeed, there are good reasons for believing that 
when taken into the circulation, the effects upon the bowels and 
their contents, are, in a good degree, prevented. 



AND THERAPEUTICS. 167 

In order to the catalytic effect of the remedy, it must enter 
the circulation, and, therefore, the more soluble preparations are 
better adapted to its use in this way, while they are not so useful 
as cathartics and anthelmintics. 

As a catalytic, the preparations of mercury are useful in several 
different forms of disease. In the phlegmasia, they form the 
sheet anchor with some practitioners. The explanations of the 
modus operandi for this purpose are various. In the treatment 
of acute inflammation, mercury was for a long time prescribed 
extensively, with the view of its being a powerful sedative to the 
circulatory organs, and nervous system. And while the latter is 
greatly under its influence, the antiphlogistic effect doubtless de- 
pends upon catalytic action on fibrin in the blood. Under its 
influence a kind of depletion is constantly going on ; and that of 
a kind which takes from the mass of circulating fluid the plasma 
and more nutritive ingredient, leaving it impoverished in this 
particular, as after blood letting. 

In croup, pleurisy, pneumonia, and other violent forms of in- 
flammatory disease, tending rapidly to disorganization of the 
structures involved, and effusion of fibrin, mercurials are used 
with happy effect. Large doses of calomel have been highly 
recommended in membranous or inflammatory croup in children. 
By its catalytic action on fibrin, obstruction to the passage of air 
through the trachea, by the formation of false membrane, is pre- 
vented ; and the large doses in use for this purpose give more 
certainty of a sufficiency being absorbed to effect this object. 

Cerebro-spinal meningitis, essentially an acute inflammation of 
the cerous tissues indicated by the name, is treated successfully 
by this and other antiphlogistic means. Ptyalism is rarely pro- 
duced under such circumstances, though the bowels be not moved 
for several days. 

In no disease, however, are the good effects of mercury so per- 
ceptible and certain as that of syphilis. The certainty with 
which it is supposed to relieve this malady has given it the ap- 
pellation of " anti-syphilitic." While it is, perhaps, not so in- 
fallible as to entitle it to such distinction, yet the catalytic action 
of mercury on syphilitic virus in the blood and tissues where it 
is deposited, is a fact well established. 



i«;.s mi .,m,v 

Nothing, perhaps, is known of the manner in which the 
syphilitic matter is acted on, whether neutralized simply, dis- 
solved or decomposed. All on this subjed positively known is, 
that the effects of the vims are no more visible after it has been 

acted on l>y this and other catalytic remedies. It may bo de- 
stroyed in the blood before the effects, or "secondary symptoms," 
make their appearance, and the local lesions and disturbance of 
nutrition, caused by its deposit in the tissues, thereby prevented. 
The system may be rid of the poison, however, and a healthy 
condition restored after being thus distributed, provided there 
be no irreparable loss of structure from the destructive process 
following the deposit. 

Any preparation of mercury for internal administration may 
be used for its catalytic effects. A sufficient amount will be ab- 
sorbed, however insoluble the preparation may be, after proper 
and regular administration. The elective effects of mercury upon 
the gums and other parts of the body, make it objectionable to 
introduce excessive quantity into the circulation at one time. 
Without caution in this particular, injurious effects may result 
from the remedy, equal sometimes to the disease itself. This 
effect, however, is rarely, if ever, produced, it is said, while the 
system is under the contamination of syphilitic virus. 

Pilula Hydragyri — Blue pill Mass — is a convenient preparation 
for use, and in the dose of five or six grains, once a day, will be 
borne readily by most persons, without unpleasant effect upon 
the gums. 

Hydrargyri Chloridum Mite — Mild Chloride of Mercury — 
Calomel — will produce about the same general effects as bine 
mass, in one-fifth the quantity; say, for the ordinary catalytic 
effect in syphilis, etc., one grain every day for several days. 

As these preparations are dependent, in a great measure, upon 
acid met with in the stomach, for their solution, they have not 
that regularity and certainty of action to be expected from more 
soluble preparations. 

In acute inflammatory diseases, such as membranous croup, 
cerebro-spinal meningitis, etc., this preparation is given advan- 
tageously, in the dose of forty to sixty grain*, as an anaplastic or 



AND THERAPEUTICS. 169 

defibr mating agent. The cerebral excitement, leading to deli- 
rium, convulsions, etc., in the latter disease is also, to some extent, 
allayed at the same time, by what is supposed to be its sedative 
effect upon the brain, in large dose, as exhibited in delirium tre- 
mens, convulsions of children, etc. 

Hydrargyri Chhridum Corrosivum — Corrosive Chloride of Mer- 
cury. This preparation is not subject in its action to the contin- 
gency mentioned above. Being readily soluble, it is promptly 
absorbed from the stomach and enters the circulation at once. It 
is a local irritant, and requires dilution when the stomach is 
empty, in order to prevent injury to the mucous membrane. An 
eighth of a grain, dissolved in two fluidounces of water, once a day, 
is the proper mode of administration. In order to guard against 
salivation, with subjects easily impressed in this way, it is neces- 
sary, sometimes, to make two days interval between the doses. 

The above directions for the administration of mercury are 
applicable to the treatment of syphilis and other chronic affec- 
tions in which the action is to be kept up for some time. When 
used in acute inflammatory diseases, the dose must be much larger 
and repeated in a few hours, if necessary. In small children, 
and adults when high arterial excitement exists, salivation rarely 
results even from large doses. 

Iodinum — Iodine. 

This substance is found most abundantly in the ashes of sea- 
weed, and is obtained in the form of dark crystaline scales of 
metallic lustre. It is soluble in alcohol, very slightly so in water 
evaporates in the air and completely volatilizes by heat, rising in 
violet coTored fumes. 

Iodine stands preeminent as a catalytic in the destruction of 
syphilitic virus, after the disease has advanced to the develop- 
ment of " secondary 7 ' or "tertiary" "symptoms." In order to 
eradicate the morbific agent, before such progress has been made, 
the use of iodine should be continued for some time after mercury 
s suspended. The system may be freed from the poison by the 
latter remedy alone, but with much more certainty when iodine 
is freely given with, and after it. 



170 A.C0L0G1 

While this remedy has obtained great celebrity on account of 
the solvent or decomposing power it exerts on fibrinous tumors, 

certain forms of hypertrophy, etc., it has not been considered 
useful as a defibrinating agent, like mercury, in the treatment of 
acute inflammation. From this difference of the c litions of 

the system in which these two articles have been thought most 
useful, it would seem that they act upon and eliminate the same 
material, though in different states. The same ingredient is 
acted on by both, but mercury is preferred while the substance 
to he dissolved is in the circulation, and iodine more certainly 
effects the object after the morbific agent has been deposited 
in the solid tissues. The same seems to be true in regard to 
syphilitic virus. Mercury eliminates it while in the blood, but 
iodine is required when it is deposited in the solids. 

The catalytic action of iodine on tuberculous and scrofulous 
matter is believed to be sufficiently certain to warrant its use for 
this purpose, while mercury is not considered applicable in these 
diseases. This is, either on account of its being incapable of 
such action, or from the fear of its impoverishing influence upon 
the blood, which should always be avoided in strumous subjects. 

Unguentum Iodinii — Ointment of Iodine — Iodine Ointment. 
This preparation is used locally for tumors, fibrinous deposits, etc. 
The surface over the affected part may be rubbed with it once a 
day, or a saturated cloth applied to the skin. In this way, and 
by the internal use of iodine, a very inconvenient enlargement of 
the thyroid gland, called goiter, and other fibrinous deposits may 
be removed. The results of rheumatism, such as enlargement 
and stiffness of the joints are also properly treated by this means. 

Potassii Iodidum — Iodide of Potassium. This soluble salt of 
iodine has almost superseded all other preparations for internal 
use. In the treatment of primary syphilis, five to eight grains 
three times a day, dissolved in water, simple syrup, or some prep- 
aration of another catalytic remedy, is a favorite prescription in 
primary and secondary syphilis. 

When the disease is of long standing and has reached the 
secondary or tertiary stage, particularly the latter, much larger 
doses are used. Twenty, thirty, and even .sixty grains! three times 



AND THERAPEUTICS. 171 

a day, may be necessary in tertiary syphilis; at the same time 
protecting the stomach from irritation, by copious draughts of 
water or flaxseed tea. In this way painful nodes and unhealthy 
ulceration are sometimes relieved as by a charm. It is believed, 
as above stated, that the pain and immobility about the joints 
from fibrinous deposits on the theca, etc., called chronic rheuma- 
tism, may also be relieved by this remedy, in the dose of ten to 
twenty grains. 

Tinctura Iodinii — Tincture of Iodine. Recent experiments 
made with the tincture and watery solution of iodine, seem to 
justify the opinion that these preparations are equal to the iodide 
of potassium in the treatment of secondary syphilis and other 
diseases, if given in correspondingly large doses, say twenty to 
sixty drops. Being much more economical preparations, there 
is no reason why they should not supersede the expensive iodide, 
should the above suggestion be verified by more thorough inves- 
tigation. Poisonous quantity may be avoided by gradual increase 
of the ordinary full dose. 

LugoVs Solution consists of forty grains iodide of potassium 
and twenty of iodine, to seven fluidrachms of water. This forms 
a concentrated watery solution, and may be used in the dose of 
ten drops for the ordinary effects of iodine ; and is preferable to 
the tincture for local application. 

Preparations, in which mercury is combined with iodine, afford 
convenient forms for the administration of both remedies at the 
same time, in cases which do not require large doses of iodine, 
nor its continuance longer than mercury can be taken with pro- 
priety. 

Hydrargyri Iodidum Viride — Protiodide of Mercury — Green 
Iodide of Mercury. This is a greenish-yellow powder, insoluble 
in water, and may be given in the dose of one grain, in the form 
of pill. 

Hydrargyri Iodidum Rubrum — Biniodide of Mercury. This 
is in the form of red powder, and is called the red iodide of 
mercury. It is insoluble in water, excessively irritating and 
poisonous to the alimentary mucous membrane, in excessive quan- 
tity. The dose is one-tweljth of a grain, and is more conveniently 
given in the form of pill. 



L?2 ACOLOGY 

These combinations do not allow very decided iodine effect, 
without the risk of injurious mercurial ization, and, therefore, no 
practical advantage can be derived from them beyond that of the 
remedies used separately. Indeed, failure to realize the lull 
benefit of iodine may depend upon its use in combinations of 
this kind. The union of iodine with iron is less objectionable, 
since both ingredients entering into the combination, may he given 
with impunity tor any desirable length of time. 

Ferri Iodidum — Iodide of Iron — is a greenish, deliquescent 
erystaline substance, with styptic chalybeate taste. This com- 
bination serves the purpose of ferruginous preparations, but it is 
not used in quantity sufficient to obtain the full effects of iodine 
that arc sometimes desirable, as in the compounds of mercury. 
There arc cases, however, of impoverished blood, containing at 
the same time morbific agents subject to the catalytic action of 
iodine, in which the combination is useful. Scrofula, tubercu- 
losis and depraved syphilitic constitutions are of this kind, and 
in which it is of the utmost importance to give the blood an in- 
crease of red corpuscles while the fluid is being rid of mor- 
bific matter. The done is one grain, in solution or made into 
pill. 

Syrupus Ferri lodidi — Syrup of Iodide of Iron. This is the 
best form in which to preserve from deterioration this compound 
preparation of iodine, and even it is liable to decomposition 
unless properly made. The dose is from twenty to thirty drops, 
diluted well with water at the time of taking, so as to prevent 
injury to the teeth and irritation of the stomach. 

Sarsaparilla. 

The root of Smilax Officinalis and Smilax Sarsaparilla. The 
former grows abundantly in, and is sent into commerce from, 
Mexico and the Central American provinces, particularly Hon- 
duras. The latter is indigenous, and is found in considerable 
quantity in many portions of the Southern States. Both are 
trailing plants, with long, slender grayish colored roots. The 
drug obtained from the two species is similar in appearance and 



AND THERAPEUTICS. 173 

medicinal properties. Most of the root found in market is 
shipped from the Bay of Honduras, and is called Honduras 
Sarsaparilla. 

This is, doubtless, a valuable drug, but has been used exten- 
sively in the treatment of affections over which it has no control. 
Like other remedial means gaining celebrity in the cure of cer- 
tain diseases, its application is made too general. It has not only 
been used as an "alterative," so-called, from which it became a 
popular remedy, but as a digestive and nervous tonic, heematinic, 
etc. Its good effects, however, are perhaps realized only in its 
use as a catalytic in syphilis, scrofula, and the results of chronic 
rheumatism. It is a "purifyer of the blood/' only when this 
fluid contains morbific agents subject to its catalytic action. 

Syrupus Sarsaparilhe — Syrup of Sarsaparilla — is one of the 
most convenient and useful preparations of the drug. In the 
dose of half a fluidounce, three times a day, its impression will 
gradually be made. In this form it can be used readily in con- 
nection with iodide of potassium, by dissolving the latter in pro- 
portions suited to the amount of iodide requisite in the particular 
case. From a half to one troyounce or more of the iodide of 
potassium may be dissolved in a pint of syrup of sarsaparilla, 
according to the amount of iodide required, and a tablespocmftd 
given three times a day, 

The fluid extract is a more concentrated preparation, and may 
be used in the dose of a fluidrachm. 

Stillixgia — Queen's Delight 

The root of Stillingia sylvatica, an herbaceous plant, with per- 
ennial root, native of the United States, and found abundantly in 
the sandy portions of South Carolina, Georgia and Alabama, The 
root, which is thick and woody, sends up, in the Spring, stems to 
the height of two or three feet. 

Stillingia may be used alone or with sarsaparilla in the treat- 
ment of syphilis, scrofula, and other conditions in which the 
catalytics, already noticed, have been found useful. 

A syrup of sarsaparilla and stillingia, though not recognized 



174 LCOLOGl 

by the Ias1 edition of the Pharmacopoeia, is a popular preparation, 
in which iodide of potassium is dissolved for the treatment of 

Syphilis, certain cutaneous affections, etc. ; the dose is a lia/f to <>n< 
fluidounce, regulating the quantity of iodide to -nit the particular 
case under treatment. 

A decoction is made by boiling a troyounce of the bruised root 
in twenty tluidounces of water, down to a pint. Doge, one or tiro 
fluidounces. The tincture maybe used in the dose of one fluid- 
nic/nn. 

Arsenk ;um — Arsenic. 

Arsenic is a grayish crystalline, brittle metal, having, when 
recently broken, a brilliant metallic lustre and granular appear- 
ance. It is tasteless, but emits a peculiar odor when rubbed. 
This metal unites with oxygen in proportions to form arsenic 
and arsenious acids. The latter is officinal and technically called 

Acidum Arseniosum — Arsenious Acid. This acid, when re- 
cently prepared, is in the form of a transparent mass and is readily 
soluble in water, but when exposed to the air for some time, 
falls in to an opake white powder, without odor or taste, and 
soluble in water only to a limited extent. In this form it is 
usually found in the shops, is called arsenic and may be mistaken 
for calomel or other substances of similar sensible properties. 

Arsenious acid, though a virulent poison of the narcotico- 
irritant variety, is a valuable medicinal agent, and may be used 
without the slightest risk of unpleasant or poisonous effects. Its 
raodas operandi, like most others of this class, has been very im- 
perfectly understood. From the want of facts as to the parts 
acted upon and the manner of that action, it has been called an 
" alterative," in accordance with the mysterious change effected. 
It has long been used as such in chronic cutaneous diseases, which 
are probably the result of some morbific material deposited from 
the blood in the skin. With this view of their pathology the, 
action of a remedy ridding the system of this irritating cause, 
can with propriety be called catalytic. 

Moreover, comparatively recent experiments with arsenic in 
the treatment of cancer seems to prove, beyond contradiction, its 



AND THERAPEUTICS. 175 

catalytic influence on cancer cell. A test is now being made, 
tinder our immediate supervision, of its virtue in this respect, 
which promises very satisfactory results. Should this dreaded 
poison be found to control cancer, a disease of all others the 
greatest terror of mankind, a nation's gratitude is due the laborers 
in its discovery. Hunt, Feb ure, and more recent therapeutists 
have testified of its virtues in this disease, and in the absence of 
other constitutional means, why may not a trial be made in all 
cases where the destructive process has not advanced so far as to 
preclude the possibility of recovery? 

The local application of arsenic openly, and as the chief in- 
gredient in nostrums prescribed and vended by empirics, has 
for a long time been practiced in the treatment of cancer. There 
is no good reason for supposing, however, that any escharotic, 
however active, can supersede the knife in removal of cancerous 
tumors ; and for its catalytic action, if such it possess, certainly 
the internal administration is preferable. Its use for several 
months is necessary in order to test thoroughly its efficiency in 
cancerous constitution. • 

In the treatment of chronic intermittent fever, neuralgia and 
rheumatism, arsenic is a popular remedy. Its mode of action 
in the relief of these affections is not positively known. It cer- 
tainly is a neurotic as well as catalytic, and as these affections 
probably all depend on nervous disturbance, it is not strange 
that arsenic in their cure should be called a nervous tonic. On 
the other hand, it must be remembered that it is only in the 
chronic form of these diseases that arsenic is found particularly 
useful ; and if from a tonic property, similar to that exercised 
by quinine, in arresting their paroxysms in the acute form, why 
has it not been found useful for this purpose? Perhaps all is 
due to catalysis, for arsenic is not likely to prevent an expected 
paroxysm of intermittent fever, nor of the other diseases named. 
When, however, their recurrence is temporarily arrested by ap- 
propriate means, and from some seemingly latent cause there is 
proneness to a return, arsenic may be given with the expectation 
of counteracting this tendency. 

The peculiarity of intermittent fever, in its periodical par- 



176 LCOLOO 

oxymSj is most remarkable, and the pathalogical condition upon 
which depends the liability to return after perfect freedom from 

all the symptoms for three week-, has eluded the vigilance of the 
most critical investigators. It is evident that the disease in 
question originates in poisoning of the cerebro-spinal nervous 

centre by what is called malaria; and whether this poison i- of 
cryptogamous, or other origin, it is not unlikely that a wander- 
ing ger in finds a nidus in the blood vessels or elsewhere, and that 
its period of incubation is measured by the length of respite from 
disease. 

According to this theory, the action of arsenic in the cure of 
chronic chills may appropriately be called catalytic. The dose of 
arsenious acid in substance is about one-sixteenth of a grain, 
gradually increased to an eighth. 

Liquor Potassii Arsenitis — Solution of Arsmite of Potassium. 
This preparation, also called Foivler's solution, from its originator, 
is in general use for the internal administration of arsenic. The 
combination with potassium does not change the medicinal prop- 
erties of the acid. The salt is expected to liberate the arsenious 
acid, by coming in contact with acid in the stomach. Half a 
grain of arsenious acid is contained in each fluidrachm of the solu- 
tion, and the dose is, therefore, about ten drops, gradually increased 
to fifteen. 

Various combinations of arsenic with iodine, quinine and iron 
are officinal, and may be used according to the indications in 
particular cases. 

Acidum Sulphurosum — Sulphurous Acid. 

It has been ascertained that this acid will destroy the micro- 
scopic sporules necessary to fermentation. When it is added to 
vinous or malt liquors undergoing this change, the process is ar- 
rested. This fact led to a test of its catalytic action on similar 
organisms in fluids of the human body. 

Diseases called zymotic are supposed to arise from the presence 
in the blood, and in other fluids, of fermenting germs; and it is 
thought that though the effects produced cannot be allayed at 



AND THERAPEUTICS. 177 

once, yet the derangement in the fluids, upon which they depend, 
may be counteracted by this remedy. To this end the acid has 
been recommended in typhus, typhoid and malarial fevers 
scarlatina, cholera, etc. Favorable reports of its action in this 
way have been made. 

This acid, like arsenic, is preferred in the form of salt, from 
combination with one of the alkaline bases, sodium, potassium, 
lime and magnesium. Almost any acid met with in the stomach 
readly iunites with the salifiable base of the salt, and extricates the 
acid. These are called sulphites, and may be given in the dose of 
sixty , grains dissolved in water. 

Chloroformum — Chloroform, 

This liquid, described under the head of cerebral stimulants 
is known to produce catalytic action in uraemia. Chloroform 
has been successfully used in puerperal eclampsia, but, no doubt, 
with a misapprehension of its modus operandi. Being a cerebral 
stimulant, it is natural to conclude that through this action the 
convulsions are arrested. The correct theory, however, is doubt- 
less that which ascribes its usefulness to the catalytic influence 
upon urea, which accumulates from scanty diuresis, and consti- 
tutes the injurious ingredient of the blood. It is now considered 
a sufficient indication for its use to find, in the latter stage of 
pregnancy, greatly diminished quantity of urine even without 
the presence of convulsive symptoms. Albumen is generally 
detected, under such circumstances, in the urine. Does not the 
fact that chloroform forms a gelatinous combination with al- 
bumen warrant the experimental use of it in albuminuria ? It 
seems reasonable so to conclude. 

Ammonii Chloridum — Chloride of Ammonium. 

This is a tough fibrous, translucent salt, inodorous, of pungent 
taste, and soluble in water. 

It is said, by Dr. Wood, to act as a stimulant, and from its 
effects in certain forms of nervous disturbance, is supposed to be 
an excitant of the neryous centres. 
12 



[78 ECOLOGY 

As a catalytic, i( has been found useful in hypertrophy and 
independent fibrinous growths. Iir its tendency to the solution of 
fibrin, whether organized or not, there is a striking resemblance 

to the action of iodine and mercury. Its use is not limited to 
the removal of solid structures, but, like mercury, is recom- 
mended in inflammation, and probably proves useful by its de- 
structive action on fibrin in the blood. In the treatment of 
such tumors, its local, as well as internal use, has been resorted 
to. A cloth applied to the skin over the tumor, and saturated 
as it becomes dry, with a solution of this salt, at the same time 
taking it internally, is a favorite mode of treating such affections 
by some practitioners. It would seem, however, that of the 
quantity which niay be taken into the stomach with impunity, a 
sufficient amount may be used in this way, without depending 
upon its tardy absorption from the skin. The refrigeration, 
however, produced by its external application, may materially 
aid in the reduction of superficial growths, and to this probably 
is due most of the benefit derived from this mode of application. 
Muriate of ammonium has been, for a number of years, recom- 
mended in chronic bronchitis. Whether as an antiphlogistic, 
by its lessening the exciting quality of the blood, or as a catalytic 
of the tuberculous degeneration which sometimes leads to bron- 
chial irritation, is not certainly known. The latter is more likely, 
since defibrination and other antiphlogistic measures are not gen- 
erally useful in chionic inflammation, without some other com- 
pensating property they may possess, by which the cause of irri- 
tation is destroyed. May not its good effects in this condition 
depend upon the power of decomposing, or in some way destroying 
the tuberculous matter, which, from its deposit in the bronchial 
mucous membrane, leads to bronchitis? 

In hypertrophy of the uterus dependent upon long-standing 
engorgement, this remedy has been considered useful, and is rec- 
ommended by Dr. H. V. M. Miller in most cases of engorgement 
and irritation of this organ, which lead to the various forms of 
functional derangement. The dose of muriate of ammonium is 
from five to fifteen graim three times a day, dissolved in water. 



AND THERAPEUTICS. 179 

Chimaphila — Pipsissewa. 

The leaves of Chimaphila umbellata, a small perennial ever- 
green, found in most parts of the United States, particularly the 
northern portion. The leaves, which are spear-shaped, have 
peculiar odor, and not unpleasant bitterish, astringent taste. The 
two species, C. umbellata and C. maculata, are known by the 
common name of wintergreen. 

Chimaphila (from y/lf w -> winter, and (pdsco, to love) has long 
been thought useful in scrofula, and doubtless acts as a catalytic 
upon the peculiar substance characteristic of this disease, in the 
blood vessels themselves, in the skin, cervical glands and 
wherever else deposited. It is used not only after the develop- 
ment of irritation and ulceration in these locations, but in order 
to prevent such results, so soon as evidences of the disease are 
manifested. In strumous subjects, this remedy, in connection with 
iron or other hsematinics, serves to prevent such developments. 
As before stated, prostrating causes, such as are calculated to 
impoverish the blood and enervate the system, tend to develop 
scrofula and tuberculosis in persons of strumous diathesis. To 
prevent these results, when the state favoring them exists, the 
course just suggested is eminently proper. The catalytic action 
of pipsissewa upon scrofulous matter that may exist, together 
with supporting and invigorating means, proves serviceable in 
arresting the disease. 

Decoction is the form in which pipsissewa may be conveniently 
used. The dose of this is about four fluidounces three times a 
day. 

A syrup has also been prepared for use, and given in the dose 
of about one fluidounce. 

We have now concluded the consideration of prominent cata- 
lytics, such as have generally been recognized as "alteratives" 
or "eutrophics." There are many other articles that have this 
action in some degree, a few of which we shall mention, without, 
however, an extended account of them or prominent position in 
the class. Amongst these, some may be found .to possess even 
more active qualities than those now mainly relied on, when 



180 ECOLOGY 

thorough investigation of their properties shall have been had. 

Manganese, though the metal was discovered nearly a century 
since, is not very well understood, so far as the direct physiologi- 
cal effects of its preparations are concerned. 

PermanganaU of Potassium, judging alone from its powerfully 
disinfectant property, may be found eminently useful in the de- 
struction of morbific agents in the fluids and solid tissues of the 
body. Indeed, experience proves its catalytic action in ehronie 
rheumatism and certain forms of uterine disease. The dose is 
one or two grains three times a day. It is best kept in the form 
of solution for use, on account of its deliquescent character. 

Bromide of Potassium is said to resemble the corresponding 
preparation of iodine, and, by Ricord, thought to be inferior to it 
in the treatment of secondary syphilis, only in acting more 
slowly. As a discutient, in scrofulous tumors and goitre, its re- 
puted action is similar to that of iodine, and, like it, is also applied 
locally, in the form of ointment, in superficial tumors. So far 
as tested, this remedy seems to have catalytic power over the 
same substances acted upon by iodine, and besides this, has also 
a decided influence upon the nervous system. 

Galium aparine, Walnut leaves, Mezereon, Sulphur, Rumex 
Xanthoxylum and convallaria are mentioned in connection with 
alterative action by authors, but their reputation as catalytics 
will not warrant confidence in their use. 

Antacida — Antacids. 

This variety of catalytics, as the^name implies, destroys acids, 
and does so by combining with and forming neutral salts. They 
are intended to affect acids which may exist in the alimentary 
canal, in the blood and in the urine. Antacids have not hereto- 
fore been considered in works on Materia Medica, under the 
same head with the preceding articles, or those usually denomi- 
nated alteratives, but since all alike produce their effects by cata- 
lysis, according to our theory of their action, they should cer- 
tainly be associated in the same class. 

The substances which neutralize, destroy or eliminate acids 



AND THERAPEUTICS. 181 

are alkalies, alkaline earths and their carbonates. The carbonates 
are equally effectual as antacids, since carbonic, the most cowardly 
of all acids, readily gives up the base with which it is combined 
at the approach of any other acid, and is set free in the form 
of carbonic acid gas. 

A state of the digestive organs consequent upon the existence 
of various diseases, pregnancy, etc., favors the accumulation of 
acid in the prima? vise, and sometimes in the blood. This 
leads to divers unpleasant symptoms and injurious results. Ex- 
cess of acid is inferred from its presence in the excretions of cer- 
tain emunctories. When it exists in the urine, antacid catalytics 
neutralize it in the blood, and relieve the unpleasant effects upon 
the bladder, urinary passages and the kidneys themselves. Not 
only so, but the formation of calculi is often the result of exces- 
sive acidity, and hence alkalies or catalytics of acid are, under 
such circumstances, useful antilithics. 

Lithia. 

Lithia (from ?J0oz, a stone) is the protoxide of Lithium, formed 
by a union of oxygen with this metal, and recognized as one of 
the fixed alkalies. The combining number of lithium with 
oxygen in forming lithia being lower than that of calcium, sodium 
or potassium, its salts are more readily decomposed, and hence 
make better antacids or neutralizing alkalies. 

The salts of lithium readily neutralize uric or lithic acid in the 
blood, when, from functional disturbance of the kidneys, urea 
accumulates, and they, therefore become catalytics of this sub- 
stance, which often leads to formidable and even fatal disturb- 
ance of the vital organs. It has been said that insoluble lithates, 
deposited in the bladder in the form of calculi, also giving trouble 
in gout, etc., are decomposed and excreted by this remedy. Lithia 
then, if this be true, serves, not only the ordinary purpose of 
alkalies in preventing the gastric, enteric, and renal irritation 
consequent upon the presence of acid, but proves to be a solvent 
and catalytic of solid formations. 

Litkii Carbonas — Carbonate of Lithium — is a white powder, 
sparingly soluble in water, and affords a preparation by which 



18$ A-dOtOtf 

acid in the alimentary canal may be readily neutralized. The 
salt is so easily decomposed thai any acid met with in the stom- 
ach, at once unites with and decomposes it, the carbonic acid 
escaping in the form of • gas. The dose ia about five grama, and 
may be repeated every two <>r three hours, if necessary. 

Lithii Oitras — Citrate of Lithium — is a white inodorous pow- 
der, and soluble in water. This preparation may be considered 
preferable to the carbonate, when its catalytic action is to be 
effected through the circulation, as it is readily absorbed without 
decomposition, owing to its solubility in water. It is, however, 
less certain for the destruction of acid in the stomach, for the 
same reason. About ten grains may be given, dissolved in water 
and repeated at intervals of four or five hours. 

Magnesia — ^-Calcined Magnesia — is, chemically, the oxide of 
magnesium. This substance is never found in nature uncom- 
bined, and when separated from its connections and exposed to 
the air, readily absorbs carbonic acid, and becomes a carbonate. 

It is prepared, for commerce, from the carbonate by subjecting 
this salt to a red heat. In this process the carbonic acid is 
driven off in the form of gas, and the magnesia remains in a 
light, inodorous, tasteless, insoluble powder. 

Pure calcined or uncombined magnesia is a mild, unirritating 
antacid, and is extensively used by pregnant females to relieve 
acid stomach, which, with some in this condition, proves a source 
of great annoyance. It is more or less cathartic, as will be seen 
from a notice under the head of aperients, according to the char- 
acter and quantity of acid met with in the canal. When given, 
however, in greater quantity tharr is necessary to unite with ex- 
isting acid in the primse vise, it is liable to prove injurious by 
accumulating in masses, or forming a kind of coating to the in- 
terior of the bowels, consisting of the earthy substance with the 
mucus of the intestines. The quantity necessary for any given 
case must be determined by the necessity for its use; that is to 
say, the amount of acid to be neutralized. Thirty grains may 
be taken, stirred in water, and repeated if evidences of acid in 
the stomach still exist. 

Magnesii Carbonos — Carbonate of Magnesium — is in variously 



AND THERAPEUTICS. 183 

sized masses, having, when pulverized, sensible properties simi- 
lar to those of uncombined magnesia, and may be used in the 
same doses, and for the same purposes. Its combination with 
carbonic acid is so readily disturbed by the presence of other 
acids, that its union with any of them found in the stomach, is 
as speedy and perfect as if given in the uncombined form. 

Calx — Lime — chemically, an oxide of calcium, is obtained to 
supply the large demands of commerce by subjecting the car- 
bonate, or limestone, to calcination. It is found abundantly in 
nature, perhaps never uncombined, and generally in the form of 
carbonate. Marble, common limestone, marl and chalk are all 
carbonate of calcium, but with different proportions of the acid and 
base. When the carbonate is exposed to heat sufficiently to 
expel the acid, it is called quick-lime, but remains hard until 
water is added, or until it has been exposed for some time to the 
atmosphere, when it falls into a white powder, and is then known 
as slaked lime or hydrate of calcium. Iu this form it is used as an 
antacid, and though sparingly soluble in water, is sufficiently so 
to be given in watery solution, called 

Liquor Calcis — Solution of Lime — Lime Water. This may be 
made by adding half a troyounce of lime to a pint of water. 
The clear solution can be poured off and taken in the dose of 
three or four fluidounces. 

Lime water is one of the most convenient and useful antacids 
in cases of ordinary acidity of the stomach • and in bowel affec- 
tions may be mixed with the food or remedies used in their 
treatment. The great tendency to the generation of acid in such 
diseases, and its injurious effects upon the inflamed mucous mem- 
brane, render the constant use of antacids necessary. An excel- 
lent preparation of food for children, under such circumstances, 
is made by adding one part of lime water to three or four of 
milk. With this the child may be sufficiently nourished, and 
the accumulation of acid prevented. 

Potassii Carbonas — Carbonate of Potassium. An impure car- 
bonate known in commerce as potash, is made by evaporating 
lye of common wood-ashes to a solid consistence. This, when 
partially purified by additional exposure to heat, is called Pearlash, 



184 aoouhjv 

from which the officinal carbonate may be prepared. Some im- 
purities arc said to exist in what is called the pure carbonate, 
from pearlash ; and it is only when made from the bicarbonate 
or bitartrate of potassium that it is entirely free. It is then called 

Potassii Garbonas Pwra — Pure Carbonate of Potassium. Botli 
preparations are sufficiently pure for ordinary purposes, and alike 
consist of a white deliquescent salt. 

Potassii Bicarbonas — Bicarbonate of Potassium — has the ad- 
vantages of being permanent in the air, more pleasant to the taste 
and acceptable to the stomach. It is soluble in water, and in 
medicinal properties similar to the carbonate. 

These salts of potassium are useful catalytic antacids, and may 
be given in the dose of twenty to forty grains dissolved in water, 
for excessive acidity whether of the blood or alimentary canal. 
In diarrhoea and dysentery, or in duodenitis, leading to imperfect 
discharge of bile into the bowels, and consequent jaundice, the 
regular administration of this alkali is decidedly useful, in order 
to the destruction of the constantly accumulating acid, which 
tends to irritate the inflamed surface. It may sometimes be ad- 
vantageously combined with other remedies, not incompatible. 
It may be used in acid urine with the effect of changing the 
character of this secretion in a few hours, by its catalytic or 
antacid effect upon the blood. 

Soda and Ammonia are alkalies and may be used also as 
antacids. 



AND THERAPEUTICS. 185 



SUB-OKDEK, IT. 

ELECTIVE ACTION THROUGH VITAL PROCESS. 



DIVISION I. 

REMEDIES THAT AFFECT THE ALIMENTARY CANAL. 



CLASS I. 

INVERSE GASTRIC EXCITANTS, OR EMETICS. 

Peristaltic, peristalticus — from TrepeaveXXo), to contract 
around — implies the force given by the muscular coat of the ali- 
mentary canal upon its contents. This, when exerted in the nat- 
ural way, carries the food downward from the stomach through 
the intestines, but when inverted, forces it in the opposite direc- 
tion, and leads to the result called emesis. The inverted peris- 
taltic force sometimes affects the small bowels, and, notwith- 
standing the valvular construction of the pyloric orifice, their 
contents regurgitate into the stomach. 

According to the generally accepted definition of emetics, the 
class includes only such articles as have elective action, exciting 
inverted or reversed peristaltic contraction. Hence, they are 
understood to be such remedies as produce this movement, with- 
out the stimulus of bulk, or the sympathetic influence of taste or 
smell. This definition excludes from the list the mechanical and 
other local means, used as adjuvants in the production of vomit- 
ing. Large draughts of warm water, salt water and mustard 
water are used in connection with the administration of emetic 
remedies, under particular circumstances, to aid in evacuating 
the stomach. When the usual sensibility of the organ 
has been obtunded from any cause, it does not readily respond 
to the natural impression of emetics, until aroused to activity by 
mechanical pressure, from repetition, or from the irritation of local 



186 ACOLOGt 

excitants. Sometimes these alone, without the specific influence 
of true emetics, promote vomiting. 

In order to distinguish elective, specific or true emetics from 
those means which do not possess such property, i< is only neces- 
sary to determine whether a given medicine will affect the 
stomach in this way, when introduced into the rectum or any 
other part of the body. Vomiting is as readily induced by an 
emetic proper, when injected into the rectum as when admin- 
istered in the stomach. Absorption of it into the circulation is 
all that is necessary, in order to the inverted peristaltic action. 
Not so with mustard and other local excitants, which, though 
they lead to the same movement, do so indirectly by exciting first 
the mucous coat. 

The manner in which immediate influence is exerted by these 
upon the stomach, as well as the way in which all other elective 
agents affect the organs for which they have specific affinity, 
afford a subject for controversy. Some suppose the particular 
ganglia, or portions of .he nervous centre supplying an organ 
directly, receive the impression of the remedy, and that the phe- 
nomena exhibited in the functional modification of such organ 
are only the result of nervous changes. This view- seems to be 
made plausible by the fact that nervous impressions bring about 
results similar to those following the use of agents called elect- 
ive or specific upon the organ itself. Thus, a blow upon the 
head, or violent shock to the nervous system from serious in- 
jury to any part of the body, may lead to vomiting. Exces- 
sive mental agitation sometimes affects the functions of cer- 
tain organs in the same manner as remedies whose action is 
directed specially to them. Opium, which is known to affect 
directly the brain, often leads to nausea and vomiting after the 
primary or exciting impression upon the nervous centre has sub- 
sided. Such incidental disturbance is observed in various organs, 
not only from opium, but other neurotics. None of these exam- 
ples, however, come up to the regularity, promptness and certainty 
which characterize the action of elective agents; and, although, 
in the present state of our knowledge, we cannot understand the 
vital or physical changes produced in certain parts by contact of 



AND THERAPEUTICS. lg? 

the remedy, brought througli the circulation, yet that such im- 
pressions are made we are forced to admit. 

The mechanical influences brought to bear in the act of vom- 
iting are threefold. The abdominal muscles, the respiratory 
organs and the stomach itself are more or less concerned. Nausea 
accompanied generally with an increased secretion of saliva, is 
the premonitor of the act. Suddenly, in the midst of this dis- 
tressing sensation, the lungs are filled with air, the glottis is 
closed and the abdominal muscles contract violently. In con- 
nection with this effort, it is supposed that inverted muscular 
contraction of the stomach also takes place. This is inferred 
from the fact that vomiting sometimes occurs when no evidences 
of external force are manifested. "Spitting up the food/ 7 as it 
is called, evidently depends upon the inverted action of the 
stomach. This occurs often without nausea, and the amount 
discharged is more or less abundant, according to the extent and 
violence of the contraction. The respiratory organs aid in the 
evacuation, only by affording resistance to the pressure in that 
direction, from contraction of the abdominal muscles. The force 
thus exerted by them not only aids materially in evacuating the 
stomach, but, together with the inverted peristaltic action of the 
small intestines, often forces through the pyloric orifice, fluid 
contents of the duodenum, noth withstanding the valve-like open- 
ing through which it has to pass. Bile is frequently found in 
ejections from the stomach, particularly after several efforts to 
vomit, being driven through the orifice by these forces. 

The immediate effects of this class are : 1, evacuation of the 
stomach; 2, modification of the circulation, from pressure upon 
the organs and large blood vessels of the abdomen, in the act of 
vomiting; 3, sedative influence upon centres of the circulatory 
and nervous systems; and 4, general relaxation of the muscular 
and other soft tissues. The first two are the result of elective 
vital action, but purely mechanical in themselves ; the latter are 
therapeutic changes in the circulation, through the physiological 
action of a nauseant upon the stomach. The objects had, then 
in the use of this class are: to evacuate the stomach; to force 
the blood from the central vessels to the periphery ; and to cause 
relaxation and sedation. 



18$ acotocrt 

For febrile ami inflammatory diseases, discharging the stom- 
ach of its contents is not so important as some suppose. In 
malaria] and other fevers this class is often used to advantage, 
and the benefit improperly ascribed by many to the mere evacu- 
ation of bile and other vitiated secretions. So far from this be- 
ing the true mode oi affording relief by them, under such cir- 
cumstances, the bilious discharges are doubtless forced into the 
stomach from the duodenum, mechanically, in the act of vomit- 
ing, and would probably never have found their way into the 
stomach at all, but for the contraction of the intestine and the 
pressure produced. 

While it is not denied that the secretions of the stomach, acid 
accumulations and improper quantities and qualities of food 
may, in fevers or other diseases, prove injurious, and should be 
evacuated, yet in a large majority of cases in which the benefit 
derived from these remedies is attributed to this, the equalizing 
effect upon the circulation and the sedative and relaxing influence 
are those to which the relief is due. 

The advantages derived are not, therefore, in proportion to 
the amount discharged, but, on the contrary, when least is evac- 
uated, relief is often more decided, the nausea and effort to 
vomit being greater. In malarial fever, particularly that form 
called "congestive" or " pernicious/' in which the circulation is 
feeble in the extremities, the surface of the body cool, with sense 
of great heat and oppression of the central organs, vomiting 
induced in any way, so as to bring to bear the mechanical press- 
ure necessary to force from the internal organs the accumulation 
of blood, tends to relieve this unpleasant and dangerous condi- 
tion. This cannot be relied on alone, however. That state of 
the nervous system upon which the congestion mainly depends, 
demands prompt attention. If the stomach be selected for the 
application of cerebral stimulants under such circumstance-, 
emetics are, of course, inadmissible, on account of the importance 
of having the neurotic remedy retained. 

The nausea accompanying the action of emetics, from its gen- 
eral relaxing influence and depressing effect upon the circulatory 
system, is made useful in the treatment of inflammatory diseases. 



AND THERAPEUTICS. 189 

Their full benefit in this way may be obtained without vomit- 
ing, bv giving occasionally a quantity not sufficient to produce 
the full effect. 

Some of the articles belonging to this class have elective sed- 
ative properties, and in quantities insufficient to produce even 
nausea, may be given as arterial or cardiac sedatives. These, 
however, are named as such in their appropriate class, without 
any reference to the emetic property which they possess. 

The complete relaxation attending excessive nausea has been 
made useful in reducing strangulated hernia, and also in soften- 
ing the unyielding os uteri sometimes found in labor. 

Three or four practical divisions of these remedies may be 
made in describing the peculiar effects of articles belonging to 
the class. The arrangement of some authors, grouping together 
for description all those of vegetable origin as one variety, etc., 
has no practical importance; but when those having in common 
the same prominent medicinal peculiarity are associated together 
for study, the same advantages claimed for general classification 
are secured, to which we have already alluded. 

Some emetic remedies produce nausea and vomiting without 
any depressing influence upon the central organs of the circula- 
tory or nervous systems, further than that resulting naturally 
from nausea. Others prove not only sedative to one or both of 
these centres, but highly irritating to the stomach itself. There* 
are those also which, while they produce full vomiting much 
more promptly than ordinary emetics, do so without the usual 
attendant nausea to any extent. With the view of impressing 
these practical peculiarities of articles belonging to the class, 
they will be found, in the catalogue below, arranged in reference 
thereto, and in the order observed above. 

Catalogue of Inverse Gastric Excitants or Emetics. 

Ipecacuanha, Antimonii et Potassii Tartras, 

Gillenia, Zinci Sulphas, 

Sanguinaria, Cupri Sulphas, 

Tabacum, Cadmii Sulphas, 

Lobelia, Hydrargyri Sulphas Flava, 



190 A.COLOG 

I i'i:( \< ianiia — Tpecac. 

The root of Cephaelis Ipecacuanha, a small shrub found in 

Brazil. The root is collected by the natives, and makes a com- 
modity in the commerce of South America. This root, when 
dried, is of an ashy-brown color, and has a peculiar wrinkled 
and contorted appearance, with transverse fissures in the hark so 
deep as to penetrate even to the small ligneous portion in the 
centre. These transverse fissures or sulci encircle the root near 
each other, and give to it the appearance of small blocks strung 
upon a cord. The activity of the drug resides in the cortical 
portion, and when pulverized, the remedy is more or less active 
accordingly as the woody portion is excluded from the powder. 

Ipecac, when pulverized, has a light ashy color and slightly 
bitter, nauseous taste. The odor is disagreeable to most persons, 
and becomes more so by associating in the mind all the unpleas- 
antness attending its operation, with the appearance and odor of 
the drug. An idiosyncrasy exists with some asthmatic subjects, 
by which a small portion of the powder exposed in a room, ex- 
cites in them a paroxysm of the disease instantly. 

The alkaloid principle upon which its virtues depend, has 
been separated and called ernetin. 

The physiological action of ipecac is ielt in the inverse peris- 
taltic contraction, and consequent reflex excitement of other mus- 
cles concerned, leading to nausea and vomiting, with their con- 
sequences ; and to these all therapeutic results are due. 

As it may be used safely where any other emetic is tolerated 
ipecac can be given effectively as an evacuant, nauseant, or for 
mechanical pressure on the abdominal viscera — the quantity to 
be administered being always modified by the object sought. 

Pulverized Ipecac is kept by druggists, and in this form, with- 
out further preparation, is often dispensed by the apothecary. 
It is administered by temporary mixture with water, and in the 
dose of twenty grains will usually produce nausea and vomiting 
in about thirty minutes. When it is desirable to protract the 
nausea, five grains may be given at intervals of an hour, and in 
this way the effect may. be continued without producing emesis. 



AND THERAPEUTICS. 191 

Ten grain* will often excite free vomiting, and in this quantity 
it may be taken for its full effects. 

Vmum Ipecacuqnhce — Wine of Ipecac. — This is a more agree- 
able preparation, the taste being less offensive, and the quantity 
taken less bulky. The active ingredient is already dissolved by 
the wine, and is therefore more readily absorbed by the veins of 
the stomach. A less amount of the drug will probably, there- 
fore, effect the desired action, than is required by a crude prepar- 
ation. When, however, the alcoholic constituent of the wine is 
objectionable in any particular case — which is rarely, if at all, 
met with — some other preparation should be selected. 

Half a fluidounce, repeated in an hour, if necessary, is the 
proper quantity for ordinary purposes. In this amount the wine 
will have about the effect of fifteen grains of the powdered root. 
Xo very unpleasant result is likely to 
follow an excessive dose of any prepara- Fl &- lo - 

tion of ipecac ; and a repetition of this 
quantity of the wine, or even the ad- 
ministration of double the amount at 
once, would not be objectionable in 
cases requiring its full effects. 

The English and American Pharma- ^vjV^ 
copceias differ in their formulae for the V V 
preparation of this wine, and conse- \* 
quently make it of unequal strength. cephaelis ipecacuanha. 
According to the former code, a fluid- 
ounce has only twenty grains, while that prepared in this coun- 
try contains, as above intimated, the equivalent of about thirty 
grains of pulverized ipecac. 

Syrupus Ipecacuanhce — Syrujj of Ipecacuanha — affords an 
agreeable preparation for children, and, like the wine, a fluid- 
ounce contains the virtues of thirty grains of the drug. This 
is a very useful vehicle for the administration of anodyne, seda- 
tive or other remedies required along with a nauseant. For its 
emetic effect alone, the syrup will be found one of the most con- 
venient forms for the administration of the remedy. The adult 
dose as an emetic, containing the virtues of fifteen grains of 




192 



ECOLOGY 



ipecac, is half a fluidoimoe. A fluidrachm acts promptly with 
children one or two pears old. 



( riLLENiA — Indian 



Fig. 16. 




GUlmia trifoliata,. 



Physic. 

The root of QHUma 
Trifoliate, an indigenous 
herbaceous plant, found 
abundantly in the north- 
ern portion of Georgia, 
in other Southern and 
many of the Northern 
and Western States. It 
very much resembles ip- 
ecacuanha, and is some- 
times called American 
ipecac. The resemblance 
is not confined to the 
sensible properties, but 
is found to be equally 
striking in their medi- 
cinal virtues. So much 
similarity exists, that the 
sensible properties, pre- 
parations, dose and phy- 
siological action of ipe- 
cac, as given above, will 
answer for gillenia. 

Doubtless an infusion, 
made in the proportion 
of half a troy ounce of the 
bruised fresh root, to a 
pint of boiling water, 
given in the dose of three 
or four fluidounces, will 
answer all the purposes 
of the officinal prepara- 
tions of ipecacuanha. 



AND THERArEUTICS. 193 

Sanguinaria — Bloodroot. 

The rhizoma of Sanguinaria Canadensis, an indigenous plant, 
with radical lobate leaves. The root lies horizontally with, and 
is often so superficial as to be only partially beneath the surface. 
When fresh, it is of a blood-red color internally; when dried, it 
is pale, but readily assumes the original brilliant hue by being 
moistened with water on the cut surface. The odor is somewhat 
narcotic ; the taste bitter and acrid, leaving in the mouth an un- 
pleasant pungency. 

Powder is a preparation in which bloodroot may be readily 
used as an emetic in the dose of about ten grains, in the form of 
pills, or extemporaneous mixture with water. 

Infusion, made in the proportion of half a troyounce of the 
root to a pint of water, affords the active qualities of the drug ; 
the dose of which is about half a fluidounce. 

Tinctura Sanguinarice — Tincture of Bloodroot — an officinal pre- 
paration, may be used as an emetic, in the dose of two to four fluid- 
rachms. 

The action of sanguinaria is most prominently exerted upon 
the stomach, producing nausea and vomiting; but its depressing 
influence upon the brain, and local irritation of the stomach, 
must be remembered, in order to its administration safely. In 
over doses it acts as a narcotico-irritant poison. Simply as an 
emetic, it is rarely used, but in bronchial, and other pectoral 
affections, its supposed expectorant and sedative properties lead 
to its occasional administration. 

Tabacum — Tobacco. 

The leaves of Nicotiana Tabacum, an animal plant, first dis- 
covered in, and perhaps native of, tropical America, and now 
cultivated in most countries of the world. 

Tobacco, with one unaccustomed to its use, has an acrid, bitter 
taste, and narcotic odor, leaving in the fauces and oesophagus a 
burning, pungent sensation, when swallowed. 

Infusion, made with one hundred and twenty grains to the 
pint of water, is the form in which tobacco is most commonly 
13 



194 ICOLOGY. 

administered. The infusion, on account of its disagreeable 
taste in the month, is most frequently given by the rectum. 
Four fluidcnmces may 6< injected, and repeated if necessary. 

Tobacco applied to the skin is said to be effectual in bringing 
on the relaxation consequent upon nausea, and to this end the 
pulverized drug, called snuff, is moistened, spread on cloth, and 
applied to the bodies of children suffering with inflammatory and 
spasmodic diseases of the respiratory tubes. r riie uncertainty, 
however, of its action in this way, renders the mode of applica- 
tion objectionable. Of substances so powerful in their action as 
tobacco, the exact amount taken into the circulation should be 
known, which is impossible, when absorption from the skin is 
the mode of its transmission. 

The physiological effects of tobacco are protracted inverse per- 
istaltic gastric contraction, with irritation of the mucous sur- 
face, and sedation of the great nervous centre, leading to intense 
nausea, general relaxation and prostration of the vital energies. 

As a therapeutic agent, its powerfully relaxing influence is 
sought, when temporary suspension of contractile power is de- 
sirable, as in strangulated hernia, rigid os uteri in labor, illeus, 
etc., etc. 

Lobelia — Indian Tobacco. 

The herb of Lobelia inflata, an annual or biennial indigenous 
plant, found throughout the United States. The seeds and 
leaves are principally selected, but the whole herb possesses sim- 
ilar properties, and may be used in making the ordinary prepa- 
rations. 

The direct or physiological action of lobelia is exerted upon 
both the stomach and brain, in the production of results which 
follow its use. Nausea and vomiting, with nervous prostration, 
are evidences of such impressions. As an emetic, it is consid- 
ered one of the most powerful and dangerous, on account of the 
depressing influences exerted upon the nervous system, and local 
irritation of the alimentary mucous membrane. 

Its poisonous action seems to be expended especially on that 
portion of the cranial nervous centres supplying the organs of 



AND THERAPEUTICS. 



195 



respiration. Hence, in eases of fatal poisoning from lobelia, de- 
rangement of this function is a prominent symptom ; and an 
entire suspension of breathing, before other vital organs cease to 
act, is a common result, The author witnessed the death of a 
young man from this cause, in which pulsation at the wrist con- 
tinued several minutes after res- 
piration had ceased. 

Like other nauseants, lobelia 
tends to the reduction of ordi- 
nary local inflammation, by its 
relaxing effect upon the tissues 
generally, and its depressing 
influence upon vital energies of 
the system. The sedation is 
perhaps more perfect than from 
other emetics, on account of its 
peculiar influence upon the 
brain, rendering it particularly 
applicable in spasmodic condi- 
tion of the bronchia and other 
parts connected with respira- 
tion. Asthma, therefore, is es- 
pecially subject to the narcot- 
ico-nauseant action of lobelia, 
particularly when an inflam- 
matory condition of the bron- 
chia exists. Spasmodic and 
inflammatory croup, tonsil itis, 
pleurisy and pneumonia are 
also diseases in which the con- 
ditions exist favorable to its 
action, and for which it is ad- ■ 
vised as a use-ful remedy. 

Owing to the severity of its action, lobelia should not be used 
merely to evacuate the stomach, nor in slight affections when a 
less violent remedy will effect the object in view. In small 
doses, say a fluidrachm of the tincture repeated every hour, it is 




Lobelia injlata. 



196 ACOLOGY 

said to relieve spasmodic asthma and croup, when no inflamma- 
tion exists, without producing any considerable nausea. Thia is 
probably effected by the control exercised over nerves of the 
parts, through the narcotic or cerebral influence of the remedy. 

Infusion of the leave- and stems 18 sometimes made for extem- 

poraneous prescription of the drug, but the permanent officinal 

preparations furnish more convenient forms for preservation and 
use. 

Tiiu'tura LobSa — Tmdhin of Lobelia — is more generally pre- 
ferred, and is equally as effective and convenient as any other 
preparation. In the dose of ha/f a fluidounee, full vomiting will 
usually occur; and for the nauseating effect alone, one or tiro 
fluidrachms is generally sufficient. 

Acetum Lobelke — Vinegar of Lobelia — is an officinal prepara- 
tion, and said to afford the advantage of holding in more perfect 
and permanent solution the active principle of the drug. It 
may be used in the same dose as the tincture, and with equal 
benefit as a remedy. 

Axtimonii et Potassii Tartras — Tartrate of Antimony and 

Potassivnt. 

This double salt, when fresh and properly prepared, is found 
in the form of transparent, colorless crystals, of unpleasant 
styptic taste, and readily soluble in water. As usually found in 
the shops, it is in the form of white powder, the crystals having 
effloresced by exposure to the air. It is incompatible with acids 
and alkalies; consequently, such substances should not be com- 
bined nor administered with it. 

This article is a decided irritant of the gastric mucous mem- 
brane, and occasionally produces dangerous effects. Although 
this local irritation doubtless adds to the muscular contraction 
excited by the elective physiological action of the remedy, and 
makes the vomiting more excessive, yet, on account of the gas- 
tric inflammation sometimes induced, less violent articles are 
preferable as mere evacuants of the stomach. 

Like other articles of the class, tartarized antimony is used in 
inflammatory and spasmodic diseases, on account of the nausea 



AND THERAPEUTICS. 197 

and consequent relaxation induced. In addition to this, it ex- 
erts a sedative influence over the heart's action, and but for the 
danger of producing gastro-enteric derangement, in irritable 
subjects, would be universally applicable in pneumonia, and 
active inflammation of other vital organs. Notwithstanding 
this, however, it has been often used successfully in such cases. 

Tartar emetic enters into the preparation of important febri- 
fuge and expectorant compounds; and to it is due most of the 
sedative influence exerted by them. The refrigerant and seda- 
tive compound, called " nitrous powder," contains, besides calo- 
mel and nitre, one-eighth grain of this salt. Under proper cir- 
cumstances, it may be a useful auxiliary in the treatment of 
febrile and inflammatory affections. The compound syrup of 
squills, so extensively used in the treatment of croup, bronchitis, 
etc., in children, is dependent for its virtue almost entirely upon 
the tartar emetic it contains. 

For the emetic effect, tartar emetic may be given in the dose 
ofheo grains, dissolved in water or acacia mucilage; as a nause- 
ant and sedative, one-eighth to one-fourth of a grain. Half a grain , 
repeated every thirty minutes till full vomiting occurs, will usu- 
ally produce thorough evacuation. 

Zixci Sulphas — Sulphate of Zinc. 

This salt is described under the head of cerebral tonics, and 
is referred to now only in connection with its emetic effect. 

In the dose of ten grains, dissolved in water, sulphate of zinc 
produces vomiting promptly, and owing to the short time re- 
quired to act, and to the small amount of nausea it produces, 
poisons, and other substances requiring speedy evacuation, are 
discharged readily by it. Not more than fifteen minutes are 
required for the full effect, and it is, therefore, a suitable emetic 
when opium, or other poison likely soon to destroy sensibility, 
has been taken. 

Cupri Sulphas — Sulphate of Copper. 

Sulphate of copper is found in the form of large rhomboidal 
prismatic crystals, of a deep-blue color and unpleasant styptic 



198 AOOLOGY 

metallic taste. The crystals, when exposed to the air, effloresce 
slightly, forming a powder in which the brilliant hue is lost. It 

is soluble in cold or warm water, and may be w^'d as an emetic 
in the dose of four grams, dissolved in water. 

Like sulphate of zinc, the blue vitriol is a prompt emetic, 
acting in fifteen minutes, or about half the time required for 
other emetics in common use. This differs from the preparation 
of zinc, however, in being more active and dangerous in its 
operation. The irritation produced by it in the alimentary mu- 
cous membrane, renders overdoses dangerous; and even in ordi- 
nary quantity, it should not be too frequently repeated. Ferro- 
cyanide potassium and albumen are incompatible with, and are, 
therefore, antidotes to the dangerous effects of this salt. 

While the only advantages likely to be derived from this 
agent, as an emetic, are the promptness and facility with which 
the stomach is relieved of its contents, yet it has obtained popu- 
larity as a remedy in certain inflammatory diseases Bluestone 
is a popular remedy in croup, and was used successfully in many 
cases of the pseudo-membranous variety, by a German physician. 

From the generally accepted modus operandi of emetics in the 
treatment of inflammatory diseases, it would not, however, seem 
to stand as a prominent remedy. To the nausea and sedation of 
this class are attributed most of the good effects in croup, and 
since less nausea is found to follow the sulphate of copper than 
tartar emetic, ipecac, etc., it seems just to conclude, on the recog- 
nized theory of their action, that the latter articles would be 
more appropriate remedies. 

As our knowledge of all the properties, even of remedies long 
in use, is not by any means perfect, nor our opinion of their mode 
of action always correct, it may not be amiss to test, within the 
proper bounds of caution, the correctness of this seemingly em- 
pirical course of treatment. 

Cadmii Sulphas — Sulphate of Cadmium. 

This salt resembles very mnch the sulphate of zinc, and like 
it, effloresces and becomes a white powder when exposed to the 



AND THERAPEUTICS. 199 

air. It is very soluble in water, and has an astringent, slightly 
sour taste. 

In the rlose of about ten grains, dissolved in water, it acts 
promptly as an emetic, but in excessive quantity, the poisonous 
irritation brings about similar results to those following the inju- 
dicious use of sulphate of copper. In its administration, there- 
fore, some caution is necessary, particularly, since its use has not 
been sufficiently extensive to fix, with unerring certainty, the 
exact quantity generally required as an emetic. 

It belongs to that class of emetics which act speedily, and is 
therefore useful in evacuating the stomach of recently-swallowed 
poisons, etc. 

Hydragyri Sulphas Flava — Yellow Sulphate of Mercury — 
Turpeth Mineral. 

This salt of mercury is a yellow powder, imperfectly soluble 
in hot, and less so in cold water. The taste is acrid, and when 
applied to the pituitary membrane, it acts as a powerful errhine. 

Yellow sulphate of mercury is an irritant emetic, and in over- 
quantity is likely to produce poisonous irritation of the gastric 
mucous membrane. In the dose of 'about jive grains full vomit- 
ing will be had. The promptness with which it acts, and the 
freedom from any cathartic tendency, renders this article partic- 
ularly serviceable in the speedy evacuation of poisonous and 
other injurious contents of the stomach. That tendency, in the 
action of ordinary emetics, to carry the contents into the bowels, 
by their emeto-cathartic effect, from which a poison, not dis- 
charged at once, is subjected to the absorbent surface of the whole 
canal, does not exist in its operation. 

Turpeth mineral, on account of its exciting effect locally, and 
its hepatic and catalytic action, may be advantageously used to 
evacuate the stomach of its contents, when, from insensibility of 
the organ, a less active agent would not answer the purpose; or 
when the elective actions, above referred to, be also desirable. 
It must, however, be borne in mind that, like other mercurials, 
this salt may, when not ejected from the stomach, sometimes lead 
to unpleasant salivation. 



200 ACOtOOt 



CLASS II. 

ENTERIC EXCITANTS, OR CATHARTICS. 

There is perhaps no class of remedies having a larger number 

of articles, nor one more extensively used than cathartics. They 
are in the hands of the charlatan, the nurse, and even pa- 
tients themselves; each prescribing liberally, and often greatly 
to the injury of those who swallow them. Cathartic pills, a few 
years since, were as common in families as household utensils, 
and now are frequently met with. 

The sluggish bowels of the dyspeptic are made doubly so by 
the habitual use of aperients and purgatives, taken until the ar- 
tificial becomes the only excitant to which the bowels respond. 

Enteric excitants, or cathartics, are remedies which promote 
evacuation of the bowels. In the main, discharges are pro- 
duced directly by an increase of the peristaltic motion of the 
intestines. Some articles have an elective tendency to the mus- 
cular coat; others affect the mucous surface; while a third variety 
causes only an exhalation into the canal, which not only so 
alters the consistence of the contents as to allow them to pass 
readily and briskly along the canal, but, from the stimulus of 
bulk, this excessive quantity of fluid also excites mechanically 
the muscular fibre to increased contraction. 

Cathartics, as regards the manner in which evacuation is in T 
duced, are also of three kinds: local, elective, and catalytic. To 
these may be added a variety which act mechanically, and they 
are of two kinds, viz: the means giving agitation, such as exer- 
cise, etc., and rough substances, causing mechanical irritation 
when placed in contact with the lining membrane of the intes- 
tines. Local irritation through vital process may be induced by 
the substance coming directly in contact with the mucous mem- 
brane, after passing from the stomach into the bowels, or by ab- 
sorption into the circulation, and transmission to this surface, 
upon which it exerts elective action. 

Certain substances entering the blood favor the exhalation of 
its watery constituents from various surfaces and outlets of the 



Attn THERAPEUTICS. 201 

body, lessening the amount of circulating fluid and carrying off 
deleterious solutions from the mass of blood. This is called effu- 
sion, and that substance whose exhalation or transpiration is 
effected through the mucous membrane of the bowels is called a 
cathartic, because the effusion leads to catharsis as a result. 

Cathartics affect the canal, not only in these various ways, but 
some of them exert their influence upon particular portions of 
the tube, to the exclusion of others. Thus, certain articles act 
more upon the duodenum, some upon the rectum, whilst others, 
and especially those that affect the muscular structure, seem to 
influence alike the whole of the large and small intestines, and 
perhaps also the stomach. 

The degree of action varies materially with the different means 
producing catharsis, and so important is this difference to the 
learner, that the articles of the class are generally arranged into 
sub-classes, which are named, with reference to this fact, aperi- 
ents, purgatives and drastics. 

Mild enteric excitants, aperients or laxatives gently excite the 
bowels to peristaltic action, without increasing materially the or- 
dinary healthy function. The mechanical means for producing 
catharsis generally afford about this degree of movement, and 
are resorted to in habitual torpor of the intestines. 

Thorough enteric excitaMs or purgatives act more forcibly, pro- 
ducing copious discharges, and evacuating the bowels more thor- 
oughly. These usually cause several evacuations, yet without 
any very great irritation or watery exhalation, and are resorted 
to for the dislodgment of hardened faeces, worms, other accumu- 
lations or injurious substances in the canal. 

Violent enteric excitants, drastics or hydragogues are more vio- 
lent and powerful in their action, producing more or less irrita- 
tion and watery discharges, often attended with pain. These 
are used with the view of producing counter-irritation, revul- 
sion or depletion, and require some caution and prudence in 
their administration. 

The objects of the class are: relief of habitual constipation, 
unloading the bowels of accumulation, counter-irritation, revul- 
sion and depletion. From what has been said, these, to some 



202 ACOLOo 

extent, may be understood. The restoration of lost natural 
function of the bowels, by remedial agents, sometimes becomes 
necessary, and a particular variety of cathartics is used for this 
purpose. To effect this object, mild cathartic remedies may oc- 
casionally be serviceable, yet, as has been said, their habitual use 
is often injurious in aggravating the very evil they are in- 
tended to remedy. Exercise, and other mechanical means of 
restoring energy to torpid 1 towels, are not, however, subject to 
the same objection. 

Then, one of the objects of catharsis is to relieve habitual con- 
stipation, brought on by sedentary habits, indigestionj etc., so as 
to restore and keep up the healthy function and prevent the ac- 
cumulation of hardened and irritating faeces. 

The second object, the fulfillment of which requires an in- 
creased degree of purgation, is that of relieving the canal of any 
fecal or useless and injurious contents. In ordinary disease, 
whether inflammatory or otherwise, unloading the bowels by a 
thorough cathartic not only gives comfort to the patient, but 
more perfect circulation in that region of the body, thereby less- 
ening oppression in other parts. 

The constant daily purging, often adopted by some practi- 
tioners, when but little food has been taken, and that of a qual- 
ity to leave very little fecal accumulation, is, to say the least of 
it, entirely unnecessary. Moreover, injurious effects often follow 
the practice of this useless custom. 

The other objects, viz: counter-irritation, revulsion, and de- 
pletion, are all filled by the same variety of cathartics. Drastic 
articles, such as produce considerable irritation along the track 
of the canal and watery discharges, are those selected for these 
purposes. The excitement thus set up lessens existing engorge- 
ment, or inflammation in neighboring organs or parts, on the 
principle expressed in the phrase, ubi irritatio ibi fluxus. 

By the same means revulsive action is had, necessary to re- 
lieve engorgement in the brain. Such articles tend also to the 
production of hydragogue catharsis, thereby relieving the blood 
vessels of a considerable amount of the circulating fluid, and 
afford a form of depletion. The catalytic effect of certain hy- 



AND THERAPEUTICS. 203 

dragogue cathartics is relied on by some practitioners to relieve 
the economy of noxious substances taken into the circulation ; 
and, while this view is perhaps hypothetical, wanting in well 
established facts to sustain it, the theory is worthy of more 
thorough investigation. 

It is well known that sedentary habits lead to inactivity, more 
or less, of the whole alimentary canal ; also, that a regular system 
of exercise is the best means of restoring the natural healthy 
vigor of the organs. Any means of agitating the stomach and 
bowels, such as frequent and sudden pressure, may be used for 
the same purpose, but horseback or foot exercise gives the addi- 
tional influence of gravitation, in promoting the movement of 
the contents. Exercise, therefore, though not properly consid- 
ered under the head of vital agents, is mentioned as a means of 
preventing a necessity for pharmacological excitants. A form of 
dyspepsia, accompanied with constipation, is often the result of 
deficient exercise. Such being subject to the agitating system of 
treatment, a class of empirics at one time made great to-do as 
dyspeptic doctors, whose treatment consisted entirely in "punch- 
ing" the patient, with the closed hand, in the abdomen, perhaps 
without a knowledge of the modus operandi, and consequently ig- 
norant of the cases subject to this treatment. 

Exercise, though useful in relieving habitual constipation, is so 
only w T hen the difficulty depends upon inactivity of the muscu- 
lar coat of the bowels, and even then, to be effectual, must be 
kept up regularly. 

Car bo Ligni — Carbon of Wood — Wood Charcoal — though a 
remedy for internal administration, is, nevertheless, as purely 
mechanical in its operation as that of exercise, and therefore ir- 
regularly considered under this head. Charcoal, not too finely 
pulverized, generally excites and irritates the mucous membrane 
of the stomach and bowels, by the roughness of its particles, and 
from the sympathy of contiguity, increase of peristaltic motion 
is promoted. Aside from this mechanical influence, it has no 
special medicinal virtues other than the disinfectant property it 
possesses, and by which gasses, etc., with which it may come in 
contact, are absorbed and neutralized. Upon the degree of pul- 



204 ACOLOGY 

verization, doubtless, depends it- cathartic property, and, there- 
fore, this effect cannot reasonably be expected from very finely 
pulverized charcoal. To the difference in this respect, which 
may exist in different specimens of the remedy, may, in all 
probability, be attributed the contradictory reports of its cathar- 
tic action. For habitual constipation, ten or fifteen grains may 
be taken half an hour before each meal. 

Other mechanical excitants of the bowels might be mentioned, 
such as wheat bran, bread baked of wnboUed flour, etc., but as 
these are most frequently used to affect the stomach particularly, 
(and as they do not properly belong under the head of vital 
agents) their consideration is not important in this connection. 

To syrup, molasses, and the various saccharine fruits and con- 
fections, is attributed cathartic property, and when used by the 
proper subjects, and under suitable circumstances, their laxative 
effects may be relied on. As articles of diet, they are sometimes 
selected by those with sluggish condition of bowels, in order to 
insure daily evacuations. Fruits containing a large amount of 
sugar, such as figs and grapes, may be used without additional 
saccharine substances, whilst the more acidulous have their ape- 
rient property increased by being made into the form of con- 
fection. 

Catalogue of Mild Enteric Excitants or Aperients. 

Oleum Olivae, Magnesia, 

Manna, Pulveres Effervescentes. 

Oleum Oliv^e — Olive Oil — Sweet Oil. 

The expressed oil of the fruit of Olea Europma an evergreen 
cultivated in France, Spain and Italy. It is a bland, unirritat- 
ing oil of sweetish taste, used in pharmacy, and described under 
the head of demulcents. 

Olive oil is a convenient, mild and safe excitant of the bowels, 
in the (lose of one or two fluidounces. It is a useful remedy for 
children when an irritable condition of the alimentary mucous 
membrane exists, and at the same time evacuation of the canal 



AND THERAPEUTICS. 205 

is required. The bland, soothing influence of the oil in contact 
with the surface allays irritation, while peristaltic action is gently 
excited in the muscular coat of the intestines. 

Manx a. 

The concrete exudation from the trunk and branches of the 
several species of Ornus and Fraxinus. Saccharine substances 
resembling manna, though perhaps rarely sold in commerce for 
this article, are obtained from various other plants. These are 
called false manna, and are wanting in mannite and other chem- 
ical constituents of the drug. The principal species of the two 
genera are Ornus Europoea and Fraxinus Ornus. There are 
three varieties of true manna in commerce, which differ from 
each other on account of the season of the year collected, and 
the part of the tree from which they exude. 

Flake manna flows from the upper portion of the tree during 
the heat of Summer, and is in firm, flat flakes of a yellow color. 

Common manna, is collected later in the season, and is, there- 
fore, not so solid in consistence, bright in color, nor regular in 
form. 

Fat manna is collected still later in the season, and is found 
in dark, imperfectly concreted, impure masses. 

Manna has a sweetish, not unpleasant taste, and is soluble in 
water. It may be used in substance or solution, in the dose of 
one or two troi/ounces, as a laxative; but the large quantity re- 
quired often precludes the possibility of using a sufficient amount, 
alone, to produce decided effect. Used with other and more active 
agents, it improves the taste and modifies their action. Children 
may be readily induced to eat a sufficient quantity of flake 
manna to induce sufficient movement of the bowels, should only 
slight impression be required. 

Magnesia— Calcined Magnesia. 

This substance, already mentioned under the head of antacids, 
is found uncombined, only, in the well-corked bottle of the phar- 
maceutist. 



206 ECOLOGY 

Magnesia may be given as a laxative, in the dose <>f about 
sixty grainsy triturated with water or milk, and taken in the 
form of temporary mixture while being agitated. As this sul>- 
stance uncombined i.s very slightly aperient, and is more or less 
active according to the particular acid met with in the prima? 
via*, it is difficult to estimate the quantity necessary to produce 
a given degree of action under all circumstances. We have, 
therefore, % very great uncertainty in its operation as to cathartic 
result. If but little acid be found in the stomach and bowels, 
the medicine may pass along the canal, adhering to the surface 
in a pasty consistence, and interfere with, rather than promote, 
catharsis. 

Magnesia is selected as an aperient in cases of cephalalgia, and 
other nervous disturbance from reflex influence, originating in 
the irritation of acids upon the alimentary mucous membrane. 
The double purpose of neutralizing these and evacuating the 
bowels would lead to its administration under such circumstances. 

There are three salts of magnesia, two of which are used for 
their laxative effect, and will be considered under this head. The 
sulphate — common epsom salt — producing more thorough ac- 
tion, will be noticed in its proper connection. 

Magnesii Carbonas — Carbonate of Magnesium. This is pre- 
pared from the sulphate of magnesia, and consists of irregular 
shaped masses of white color, insoluble in water and of an earthy 
taste and odor. Like calcined magnesia, it may be triturated 
with water or milk, and given in the dose of thirty to sixty 
grains. It differs very little from magnesia in its general action 
and uses, the carbonic acid giving up the base to any acid it 
may come in contact with, makes it subject to the same uncer- 
tainty as a cathartic, and answers equally well as an antacid. 

Liquor Magnesii Oitratis — Solution of Citrate of Magnesia. 
This solution is prepared by pharmaceutists from the carbonate, 
and, in addition to aperient result, the grateful influence of free 
carbonic acid gas is realized in its use. In order to preserve 
this ingredient, it is necessary to keep the solution in a well- 
stopped bottle with confined cork. It has the advantage of being 
pleasant to the taste and acceptable to the stomach. 



AND THERAPEUTICS. 207 

A solid citrate of magnesia, prepared by Dorvault, is perma- 
nently soluble in eight times its weight of water (U. S. Dis.) 

The dose of solution of the citrate of magnesia as an aperient 
is four jiuidounces. 

Pulveres Effervescentes Aperientes — Aperient Eferves- 
eing Powders — Seidlitz Powders. 

These powders are in pairs, intended to be dissolved in sepa- 
rate portions of water, and consist, respectively, of tartaric acid 
in one paper, and tartrate of potassa and soda (rochelle salt) and 
carbonate of soda in the other. These powders, dissolved in 
separate vessels and poured slowly together, make an agreeable 
effervescing draught, cooling and aperient in its effects. It is 
suited particularly to febrile conditions, in which great heat and 
thirst are present, and in which less acceptable articles would not 
likely be retained. Sometimes two powders are required to pro- 
duce the desired effect. 

Thorough Enteric Excitants or Purgatives. 

Most of the mild peristaltic excitants which have been noticed 
under the head of aperients, produce their cathartic effect by di- 
rect influence, exciting increased action in the muscular coat of 
the intestines ; and the same may be said of thorough excitants 
now under consideration. As will be seen in descriptions of the 
several articles, the larger proportion of them seem to act by 
this elective influence on the muscular fibre. A few, perhaps? 
cause catharsis by their tendency to exhalation into the canal. 

Thorough peristaltic excitants, or purgatives, serve as thorough 
evacuants in cases of fecal or other accumulations in the bowels, 
and are necessary when such become troublesome. Following 
anthelmintic remedies, they are useful in carrying along with 
ordinary contents the parasite, rendered inactive by the worm- 
poison. This becomes necessary soon after the impression has 
been made upon the worm, lest it revive and again become able 
to resist the force of cathartics. 

Purgatives should be given to females twelve hours after giv- 



2i >8 ACOLOCi V 

ing birth, if the bowels be not freely moved previously, in order 

to present unpleasant febrile excitement, at the establishment of 

lactation, three days after delivery. At this period, symptoms 
of peritoneal and metritic inflammation are Sometimes found, 
and, as the most prompt and certain relief is afforded by cathar- 
sis, it may be justly inferred that a soluble State of the bowels 
tends greatly to prevent this very painful and sometimes danger- 
ous condition. 

There are several articles belonging to the class of cathartics 
whose action is uncertain, being, like magnesia, governed by 
circumstances, and also by the quantity administered. Some of 
the more insoluble preparations of mercury, for instance, are 
dependent on the character of fluids met with in the stomach, 
for their susceptibility to absorption. 

Agahvthe degree of action is greatly modified by the quan- 
tity administered. Rhubarb and other cathartics may be made 
gently aperient or thoroughly purgative by varying the amount. 
These will be considered first under the head of purgatives, and 
the proper dose will be stated for each degree of catharsis. 

The articles next coming in order for consideration, in the 
purgative variety, produce thorough evacuation in any dose 
which is likely to act at all. 

Catalogue of Thorough Enteric Excitants, or Pur- 
gatives. 

Hydrargyrum, Magnesii Sulphas, 

Rheum, Sodii Sulphas, 

Aloe, Senna, 

Juglans, Cassia Marilandica. 
Oleum Ricini, 

Hydrargyrum — Mercury. 

This metal, described under the head of catalytics, is said to 
be inert in the pure or uncombined state, but is found to act 
promptly when reduced, by mechanical division, into minute 
particles. It is supposed that oxidation occurs when thus treated, 
and that it is thereby rendered soluble and capable of being ab- 



AND THERAPEUTICS. 209 

sorbed. In order to its cathartic effect, however, absorption does 
not seem to be necessary. Indeed, there are good reasons for 
believing that this effect depends upon its presence in the 
bowels. Mercurials introduced into the circulation in any way 
except through the alimentary canal, have no cathartic effect, but 
have elective action on the liver and salivary glands. More- 
over, it is well known that such glandular excitation does not 
take place when free catharsis follows its internal use. Now, if 
absorption be as necessary to the cathartic, as to the hepatic 
or glandular impression, both would occur under the same cir- 
cumstances. 

Pihda Hydrargyri — Pill of Mercury — Blue Pill — is a dark 
bluish mass, of suitable consistency for the ready formation of 
pills. It consists of metallic mercury, triturated with confection 
of rose and pulverized liquorice root till no globules are visible. 

Blue pill is seldom given for its cathartic effect alone, and is 
uncertain as to the time required, and the amount of purgation 
produced. In constipation, the result of a sluggish state of the 
liver, both difficulties may be met by the use of this prepara- 
tion. 

In the dose of twenty grains, blue mass will occasionally, under 
favorable circumstances, produce thorough purgation; but the 
uncertainty attending its operation, and the liability to unpleas- 
ant salivation, prevent its frequent use for this purpose. Five 
grains will sometimes produce aperient effect. 

Hydrargyri Chloridum Mite — Mild Chloride of Mercury — 
Calomel — is a white, inodorous, tasteless powder. Like other 
preparations of mercury, it is uncertain as a cathartic. Under 
favorable circumstances, however, thorough purgation may be 
expected from large doses. Not only so, but nausea and vomit- 
ing sometimes attend its action. 

In the dose of four or five grains a laxative state of the bowels 
is produced, and twenty grains will often cause free catharsis. 

Sometimes, however, the bowels remain quiet until other 

means are used, even after this amount has been taken. Large 

doses,, in cases of worms, may sometimes effect three important 

results, viz: poisoning;; and destruction of the parasite, allaying 

14 



210 



ECOLOGY 



symptoms of nervotii derangement, such ,-is convulsions, etc., 

:iikI expulsion of worms, with other contents of* the bowels. 

Rheum — Rhubarb. 



The root of Rheum Palmatum f Rhewm Compactum, and Rheum 
Undulatum, herbaceous plants, growing spontaneously in Asia, 
China, and other countries, and cultivated in Europe and Amer- 
ica. These species of the rhubarb plant differ from each other 
in the shape of their leaves, but all alike have large, branching 
roots. Other species are alluded to by authors, as the plants 
from which certain varieties of the drug in commerce is proba- 
bly derived. 

Great confusion in the statements and reports of botanists often 
arise, and doubtless from the fact that specimens of the same 
species of any plant, cultivated in different regions of the earth, 
differ widely from each other, and give rise to the contradictory 
statements as to the botanical origin of certain vegetable drugs. 
Plants, like animals, are changed by climate, soil, etc., so much 
so, indeed, that not only the species, but the genus itself, can 

scarcely be recognized 
after a succession of 
crops or generations, 
being subjected to en- 
tirely different influ- 
ences. Hence, plants 
from the same species, 
cultivated in China, 
Europe and America, 
would probably, after 
the lapse of years, as- 
sume verv different bo- 
tanical characteristics. 
A species of rhu- 
barb is culivated in this country, principally for culinary pur- 
poses. The petioles, or leaf stalks, have an agreeable acid taste, 
and are used as an article of diet in the form of tarts, etc. 




Rheum palmatn-m. 



AND THERAPEUTICS. 211 

There are three principal varieties of the drug known in com- 
merce : Chinese Rhiibarb, Russian Rhubarb, and European 
Rhubarb. These being derived from different species of the 
plant in some instances, and subjected to different modes of pre- 
paration, necessarily differ in appearance, and sometimes in their 
chemical constituents. 

After the plant attains the age of five or six years, the root is 
dug, deprived of its cortical portion, and dried. The Chinese 
variety gives evidence of the outer covering having been scraped 
off, while the Russian specimens show that the bark has been 
sliced by longitudinal incisions with a knife. By these charac- 
teristics alone, the two varieties can be distinguished. In this 
form, the roots are thoroughly dried, and pass into commerce. 

When pulverized, rhubarb is of a bright yellowish brown 
color, bitter and slightly astringent taste. It has sufficient ten- 
acity, when moistened, to be made readily into pills, and in this 
form is most conveniently administered. 

Rhubarb is one of the articles that may be relied on as a gen- 
tle laxative, in the dose of ten grains, and in double this quantity 
will usually produce thorough purgative action. It doubtless 
has an elective influence upon the muscular fibre of the intes- 
tines, and therefore evacuates them without increasing the effu- 
sion which leads to watery discharges. 

In addition to this exciting property, it is astringent and tonic. 
The astringent and cathartic properties seem to be blended in 
such happy proportions that the latter is not interfered with by the 
former, as is often the case when astringents are given along 
with peristaltic excitants. The function of digestion seems to 
be promoted by the same influence upon the alimentary canal, 
which causes the contents to pass more briskly along the tube, 
resulting in catharsis. 

There are several officinal preparations of rhubarb, by which 
its administration is facilitated, and its effects on the system 
modified. 

Syrupus Rhei — Syrup of Rhubarb — contains, it would seem 
from the formula, the strength of about eight grains in each 
fluidrachm of the syrup, and has, in addition, the laxative influ> 



212 ECOLOGY 

ence of the saccharine constituent. As there is always, however, 
more or less waste of the active principle of drugs in such pre- 
parations, it would not be proper to estimate the dose by the 
full amount used in the preparation. About two fluidrachma 
may therefore be given as a laxative, and half a fluidounce as a 
purgative dose. 

Syrupus Rhei Aromaticus — Aromatic Syrup of Rhubarb — has 
the strength of about two grains of the rhubarb to the fluidrachm 
of syrup, and contains aromatic substances which render it more 
agreeable to the taste, acceptable and stimulating to the stomach. 
In the dose of half a fluidounce, this syrup affords one of the 
most agreeable and useful aperients belonging to the class under 
consideration. 

Lxtractum Rhei Fluidum — Fluid Extract of Rhubarb. This, 
judging 'from the formula, is the most concentrated form in 
which rhubarb is found. Each minim of the extract seems to 
contain the virtues of one grain of the drug; and if there be no 
loss of the active principle in the process, ten minims will be 
sufficient as a laxative, and half a fluidrachm the full purgative 
dose. 

Other preparations, such as tincture, solid extract, etc., are 
officinal, but those already described are considered the most im- 
portant and entirely sufficient for all practical purposes. 

Aloe — Aloes. 

The inspissated juice that exudes spontaneously from the 
leaves of at least three species of Aloe, viz: Aloe Vulgaris, Aloe 
Sjjieata, and Aloe Socotrina. They are natives of Africa and 
Europe, and cultivated in the West Indies. Other species are 
said to yield the drug, but most of that found in commerce is 
probably derived from these. There are four varieties of aloes 
in market : the Cape, Socotrine, Barbadoes and Hepatic. The 
difference in appearance and quality is perhaps, to some extent, 
dependent on the species of the plant from which they are ob- 
tained, but more particularly upon the mode of preparing and 
the care with which the juice is collected and inspissated. 



AND THERAPEUTICS. 



213 



Fig. 19. 



Aloes, as found in the shops, is in irregular shaped, greenish- 
black masses, and of a shining, resinous appearance when broken. 
In the pulverized form, the color is yellowish. The taste is ex- 
cessively bitter, leaving a peculiar, pungent, disagreeable sensation 
in the fauces for some time after being swallowed. During the 
heat of Summer it becomes soft, and the pieces running together 
become a solid mass. 

Aloes yields its virtues readily to alcohol and water, and in 
the form of tincture we have an officinal preparation in which 
the alcohol serves the purpose merely of preventing precipitation 
or decomposition. The extreme bitterness of the preparation, 
however, renders the taste so intolerable that it is rarely used. 

Aloes, being tenaceons when 
warmed or moistened, may be 
made readily into pills ; and this 
is the most convenient and agree- 
able mode of administration. As 
a cathartic, it is regarded as a re- 
liable laxative in the dose of jive 
to ten grains, and may be used as 
a thorough purgative in the dose 
t of fifteen to twenty. 

Like rhubarb, it probably in- 
duces catharsis by its exciting in- 
fluence upon the muscular coat of 
the intestines, and also proves 
thereby a useful tonic to the stom- 
ach in debility of that organ with 

constipation. The impression made upon the muscular fibre is 
doubtless an elective action, and 1 in addition to this, a special 
elective influence is exerted on the mucous surface of the rectum, 
which doubtless adds to the purgative effect. At any rate, the 
rectum itself is excited to more thorough evacuation of its con- 
tents, expelling ascarides more thoroughly than other cathartics, 
aside from any poisonous influence the aloes may exert upon the 
parasite. 

This excitement of the rectum may be used to advantage not 




Aloe Socotrina. 



■2\\ LCOLOGtf. 

only for these purposes, l>ut for its revulsive influence in en* 
m« iit of the brain. Not only bo, but the excitement may 
extend, through the sympathy of contiguity, to other of the 
pelvic viscera, giving vigor to the litems when inactive from 
anaemic state of the organ. Hut on this account the remedy is 
inadmissible when the womb is already irritable, over-excited 
and engorged, or when impregnated. The rectum itself is liable 
to painful disease from the protracted use of this remedy. Te- 
nesmus and other dysenteric symptoms, with the production of 
hemorrhoidal tumors, may he expected from large and repeated 
doses of alo< 

Juglans — Bvttern ut. 

The inner bark from the root of Juglans Qinerea, or White 

]V(il nut, an indigenous forest tree, growing on fertile soil, in va- 
rious parts, of the country. 

Butternut seems to exert an elective influence upon the mus- 
cular coat of the alimentary canal, without irritation to the mu- 
cous surface; giving vigor, tone and regularity to the peri- 
staltic movement. Its action is reliable, and leads to thorough 
purgation in full doses. Unlike irritating cathartics, it leaves 
the bowels in a healthy and vigorous condition, it is said, when 
used for habitual constipation. It may be given in the form of 
decoction, but on account of the unpleasant taste, and the quan- 
tity required, this form of preparation is objectionable. 

Extraction Juglandis — Extract of Butternut — is the only offici- 
nal preparation of white walnut, and being of proper consistence, 
pills are readily made of the extract. This is a convenient form 
for administration, and they may be prepared from this prepara- 
tion, as required for use. The quantity given may be so varied 
as to produce gentle laxative effect or full purgation. Ten grains 
will answer as a certain and prompt aperient, while in the dose of 
about twenty grain* it affords an easy and thorough purgative. 

Oleum Ricini — Castor Oil. 

The expressed oil from the seeds of Ricinu.s Communis or Palma 
Chrixti. The plant is a native of the East Indies and Africa, 



AND THERAPEUTICS. 215 

where it attains the magnitude of a tree, and is perennial. It is 
cultivated in Europe, America, and other countries, in latitudes 
where it can exist only as an annual plant. 

The oil, as expressed from the seeds, is almost colorless, and 
has very little odor when fresh, but a disgusting, nauseous taste. 
When freed from the acrid, emeto-cathartic principle, which ex- 
ists in the seeds, castor oil is a mild and efficient purgative, free 
from griping and other unpleasant effects. It is, at the same 
time, a thorough evacuant, acting probably upon the muscular 
coat of the bowels electively. In order to this, it must necessa- 
rily be emulcified and absorbed into the circulation. As a rea- 
son for objecting to this manner of operation, it may be stated 
that the oil is found to pass through the bowels in its natural 
state. This fact does not, however, disprove the theory. A 
sufficient amount to produce catharsis may have been taken into 
the circulation, while a surplus, unemulcified, passes through the 
bowels. 

We have no evidence of its irritating the mucous membrane, 
or causing exhalation into the canal ; and hence, in the absence 
of proof to the contrary, we presume it operates, by elective ac- 
tion, on the muscular coat. 

In the dose of half to a fluidounce, castor oil will evacuate the 
bowels freely. Various modes of administration have been sug- 
gested with the view of concealing the taste, but, after all, per- 
haps the best is that of holding in the mouth alcohol, cologne, 
some aromatic tincture, or other pungent liquid, until its sensi- 
bility is obtunded, then, by warming, make the oil fluid as pos- 
sible, administer without admixture, and again rinse the mouth 
with the pungent liquid. 

Cabtor oil ranks high as a purgative, when the object is sim- 
ply to evacuate the canal of accumulated fa3ces, worms, etc. It 
is also considered the most useful evacuant when the system is 
under the influence of opium, as the oil is supposed to operate 
more promptly under such circumstances than other cathartics. 
Though perhaps in some degree restrained by the opiate, it will 
generally purge freely when given at the same time with lauda- 
num, morphine, etc. Hence, for colic, or other painful affec- 



216 AC0L0G1 

tions of the bowels in which anodynes are of urgent necessity, 
it is preferable as an excitant of peristaltic movement. 

Magnbsi] Sulphas — Sulphate of Magnesium — Epsom Salt 

This salt is found in the form of colorless, transparent crys- 
tals, which slowly effloresce when exposed to the air. It is 
without odor, lias a hitter, unpleasant taste, and dissolves readily 
in water. The activity is not materially affected by exposure, 
notwithstanding it loses the crystaline form, and falls into a white 
powder. In efflorescing, the water of crystal ization is lost to 
the salt, and to that extent it is lighter. Therefore, instead of 
requiring- a larger dose, when having been for some time ex- 
posed, it probably requires less by weight. 

This differs materially from the preparations of magnesium al- 
ready described under the head of aperients, both in degree and 
manner of action. While Epsom salt may increase the peris- 
taltic movement to some extent, by direct elective influence upon 
the muscular coat, yet we know that exhalation to a considera- 
ble extent is the result of its use, and on this mainly, its cathar- 
tic effect may possibly depend. For, as has already been stated 
in remarks on cathartics generally, the presence of an unnatural 
amount of fluid, poured suddenly into the bowels all along their 
extent, mechanically excites contradiction, and also reduces the 
consistence of their contents, so that they pass the more readily 
along the canal. 

In the close of a troyounee, sulphate of magnesia is a prompt 
and safe purgative, causing copious, watery discharges, without 
irritation to the mucous membrane of the intestines. By its ac- 
tion not only are the bowels unloaded of their contents, but the 
blood vessels are depleted, particularly those connected with the 
bowels; and hence, Epsom salt serves a valuable purpose in per- 
itonitis. No purgative, therefore, is better suited to the treat- 
ment of puerperal peritonitis, or more appropriate as a purgative 
just after delivery, in anticipation of such trouble. 

The same may be said of its modus operandi in the treatment 
of sporadic dysentery. With some practitioners, it is the chief 



AM) THERAPEUTICS. 217 

reliance in this affection, and doubtless mav be profitably em- 
ployed at an early period of the disease. Without adding to 
the inflammation by any irritating property, it disgorges the con- 
gested capillaries of the intestines, by causing the exhalation of 
a portion of their contents into the alimentary canal. Total re- 
liance, however, should not be placed in this purgative. There 
is a point beyond which the practitioner should not go, in the 
use of any cathartic. Restraining and nourishing means should 
take its place at the proper time, and in many instances the treat- 
ment must commence in this way. 

Sodii Sulphas— Sulphate of Sodium — Glauber's Salt. 

Sulphate of sodium is a transparent, colorless salt when fresh, 
but by long exposure effloresces, falling into a white powder, by 
which it loses nearly half its weight. It is readily dissolved in 
water, and is taken in solution in the dose of a troyounce, but 
on account of its nauseous, unpleasant taste, is seldom adminis- 
tered. The effect upon the bowels is similar to that of sulphate 
of magnesium, and, like it, requires less amount by weight when 
in an effloresced state. An extended notice is not necessary, 
since the Epsom salt, being less disagreeable, has almost entirely 
superseded it. 

Senna. 

The leaflets of three species of Cassia constitute the senna of 
commerce. These take their names from the shapes of the 
leaves. Thus, we have Cassia obovata, Cassia elongata and Cas- 
sia acutifolia. Two, at least, of these are natives of Africa, 
where they exist as shrubs two or three feet in height. 

There are four varieties of senna found in commerce : the Al- 
exandria, Tripoli, India and Mecca Senna. These take their 
names from the commercial history of the drug, and are not 
products exclusively of any particular species of the plant. 

Senna has an unpleasant odor, slightly bitter and nauseous 
taste, and yields its virtues to water and diluted alcohol. 

The leaflets, stalks and legumes have purgative properties, but 
the former only are officinal, being more effective. The legumes 
are milder in their action, and may be used as a laxative. 



218 ECOLOGY 

Senna is an elective cathartic, acting physiologically upon the 
muscular coal of the intestine-, so as to increase their peristaltic 
movement. This lias been sufficiently proven by the injection 
of an infusion into the veins, by which catharsis is readily pro- 
duced. 

Griping is a characteristic symptom in the operation ol' senna, 
yet it would seem to be the result of violent contraction in the 
muscular coat, caused by the direct influence of the remedy upon 
it, rather than any irritating effect upon the mucous membrane, 
such as follow the use of drastic cathartics. The pain accompa- 
nying its action may be measurably prevented by combining 
with the preparation, or administering separately, some aromatic 
substance, such as cloves, cinnamon or spice. Senna, compared 
with other cathartics, will be found more active than most of the 
purgatives, and less so than the milder drastics. 

The activity of senna depends upon the two constituents, 
cathartin and volatile oil, but to the former most of the peristal- 
tic excitement is due. There are several officinal preparations 
of senna, besides the compounds with other substances, and we 
shall name them in the order of their practical importance. 

Infmum Sennw — Infusion of Senna — is prepared by pouring a 
pint of boiling water on one troyounce of senna and sixty 
grains of bruised coriander; macerate for an hour in a covered 
vessel, and strain (U. S. P.) It will be observed that this ex- 
temporaneous preparation of senna contains also an aromatic, 
which is intended to counteract the griping tendency of the 
remedy, and at the same time improve the taste of the infusion. 
Thirty grains of bruised ginger will answer equally well as a 
carminative, and may be conveniently substituted for the cori- 
ander. Senna may be prepared in this way readily when re- 
quired for use. The dose is about four fluidounces, to be repeated 
in four or five hours if necessary. 

Extractwn Semue Fluidum — Fluid Extract of Senna. This is 
a concentrated preparation of the drug, without admixture with 
any aromatic substance, and requires the addition of cloves, 
ginger or some such substance to prevent the griping effect be- 
fore alluded to. It has the advantage of producing the desired 



AM) THERAPEUTICS. ^19 

purgative effect in much smaller bulk than the infusion, and 
may, therefore, be administcied in eases where a larger quantity 
would not be acceptable to the stomach. In this form senna is 
prepared by the pharmaceutist, and kept ready for use at any 
time without the delay necessary to prepare the infusion. The 
dose, as a purgative, is about half a fluidounee. 

Tinctura Sennce — Tincture of Senna — is not officinal in the 
United States, but recognized by the British Pharmacopoeia. It 
contains the virtues of coriander, an aromatic, and has the ca- 
thartic principle of senna in such a degree of concentration as 
to require only the dose of half a fluidounee as a purgative. In 
some instances, though not usually, the amount of alcohol taken 
may make this preparation objectionable. 

Syrupm Sennce — Syrup of Senna — though not officinal in the 
United States, is a convenient form for the administration of 
senna to children. With it, anthelmintic remedies can be read- 
ily administered, and the expulsion of worms effected while 
inactive, from the poison given to destroy them. For this and 
other purposes, the preparation may be given to children in the 
dose of half a fluidrachm. The purgative effect upon adults may 
be obtained in the dose of half a fluidounee. This is a convenient 
form for the administration of senna with such other remedies 
as may be desirable with the purgative. 

Cassia Marilandica — American Senna. 

The leaves of Cassia Marilandica, an indigenous, shrubby, 
perennial plant, five or six feet in height, growing in various 
parts of the Southern States. The leaves should be gathered in 
the latter part of Summer, and dried in an airy shade. Ameri- 
can senna possesses all the virtues of true senna, yet in less de- 
gree. It is perhaps subject to the same forms of preparation, 
but requires to be given in doses one-third larger. There seems 
to be no very good reason why this may not be substituted for 
the foreign varieties. 

Violent Enteric Excitants, or Drastics. 

This variety of cathartics not only evacuates the bowels, but 
serves other important therapeutic purposes. We have already 



220 ACOLOGY 

alluded to the counter-irritant, depletory and revulsive effects of 
cathartics, in giving the objects for which the class is used. 
Drastics are given for these effects, and not to answer the pur- 

of mere evacuation, since they are unnecessarily active and 
prostrating for this purpose. It is true, however, that drastic 
articles are employed sometimes along with laxative remedies 

when no other object than alvine evacuation is in view. Yet, 
in this association, the drastic loses its violence and a medium 
degree is obtained) amounting only to purgative action. 

Enteric excitants of this kind perhaps generally irritate the 
alimentary mucous membrane, and on this depends the counter- 
irritation and revulsion obtained. Exhalation also is probably 
the result of this effeet upon the inner surface of the bowels, and 
depletion, therefore, is had at the same time. 

Certain purgatives, already referred to, eause the discharge of 
fluid into the canal, by their catalytic, or some such influence 
upon the circulatory fluids. Drastics, however, produce hy- 
dragogue catharsis by irritating the mucous surface, and are 
more or less dangerous according to the condition of the patient 
and quantity administered. Even when given to robust subjects, 
many articles of this variety, used in large and frequently re- 
peated doses, prove poisonous, by the inflammatory excitement 
set up in the stomach and bowels. 

Catalogue of Violent Enteric Excitants, or Drastics. 

Jalapa, Col ocyn this, 

Podophyllum, Elaterium, 

Scammonium, Oleum Tiglii, 

Gambogia, Leptandra. 

Jalapa — Jalap. 

The root or tuber of Ip&mcea Jalapa, a twining plant, native 
of the State of Vera Cruz, Mexico, and found abundantly near 
the city of Xalapa, from which the name is derived. 

The root is imported to this and other countries from the port 
of Vera Cruz, in the form of irregular, roundish and pear-shaped 



AND THERAPEUTICS. 221 

tubers, which are pulverized by manufacturing pharmaceutists 
and kept by apothecaries in this form for use. 

Pulverized Jalap is of a yellowish-brown color, fainty odor, 
and sweetish, nauseous taste. The activity of the drug depends 
principally upon a resinous substance soluble in alcohol. Jalap, 
a leading article in this variety of peristaltic excitants, is, with 
proper caution, a safe and effective drastic. It is somewhat irri- 
tating to the mucous surface, but not sufficiently so, in moderate 
quantity, to induce very serious derangement of this kind. It 
doubtless has some direct elective influence upon the muscular 
coat of the intestines, and tendency to exhalation, aside from its 
irritating effect upon the mucous membrane. 

The rational inference, from what has been said, is, that the 
indications in peritonitis, congestion of the brain, spinal irrita- 
tion, etc., may be filled, to some extent, by this remedy when 
existing circumstances will admit of any drastic cathartic. 

Before quinine was relied on as a certain and safe cure for 
malarial fever, jalap was a popular remedy in the treatment of 
this affection. In its action, not only was the discharge of em- 
barrassing fecal contents secured, but counter-irritation and de- 
pletion of the engorged and irritable spinal cord, so constantly 
present in the remittent and intermittent forms of this fever. 
At the present day, however, it is believed that the action of 
quinine is greatly interfered with by catharsis, and that impor- 
tant time may be lost by giving this or any other cathartic, so 
as to be acting on the bowels at a time when the nervous system 
should be impressed with the tonic. 

Jalap may be given in powder by temporary mixture in wa- 
ter, in the dose of fifteen to twenty grains, or in less quantity, re- 
peated pro re nata. 

Extradum Jalapce — Extract of Jalap (U. S. D.) This consists 
almost exclusively of the gummy substance found in jalap. It 
is officinal, but as there is no practical advantage in its use over 
that of the pulverized drug, there is no necessity for extended 
notice of it. 

Resina Jalapce — Resin of Jalap — is in the form of dark-brown, 
opake masses or fragments, breaking with a resinous fracture. 



222 ICOLOGY 

It is soluble in alcohol, hut insoluble in water. It may be made 
into pills or powders, and given in the dost of about fiw grains, 
for the usual effects of the drug, as its activity depends mainly 
on this resinous ingredient. 

Tinctura Jalapce — Tincture of Jalap. — This is a concentrated 
preparation, and will he found convenient for administration 
when desirable to use a cathartic of this character in the liquid 
form. The dose is about half a fimdounce, and in this amount 
there is not a sufficient quantity of alcohol to make the prepara- 
tion objectionable. 

There are officinal compound preparations of jalap, hut the 
simple forms above mentioned can be very readily used with 
other remedies and in proportions to suit more perfectly the par- 
ticular case under treatment. 

Podophyllum — May Apple 

The root of Podophyllum Peltatum, an indigenous herbaceous 
plant, ten or twelve inches high, growing abundantly in many 
parts of the country. The root is perennial, and grows to the 
length of several feet. 

When pulverized, podophyllum resembles jalap in most of 
its sensible properties, and in this form is usually kept by apoth- 
ecaries. Equally striking is the resemblance between these arti- 
cles in their medicinal virtues, and the preparations to which 
they are subject. Some writers believe podophyllum is likely to 
produce nausea, while others deny that it has more tendency to 
disturb the stomach than other active cathartics. The powder 
may be administered in pills or mixed with water, in the dose of 
twenty grains. 

Resinia Podophylli — Resin of Podophyllum — is the principal ac- 
tive ingredient of podophyllum, and in this also a striking re- 
semblance to jalap is found. Under the name of podophylHn 
this resin of May apple has been for some time used by the ec- 
lectics as a colagogue cathartic. 

The resin of podophyllum is a convenient form for using the 
remedy, affording the essential ingredients in a much smaller 



AND TITERArEUTICS. 223 

hulk than the powdered root. It is now, therefore, the only form 
in which podophyllum is usually administered. 

The dose of this resin is ((bout half a grain to a grain repeated, 
if necessary, in a few hours. It is readily made into pills, and 
may he conveniently given in this form. 

Sc ammonium — Scamm any. 

The concrete juice which flows from incision made in the 
living root of Convolvulus Scamm oniinn, a native of Syria and 
neighboring countries. It is a gummy, resinous exudation, and, 
when inspissated, forms a dark, solid mass, which breaks with a 
waxy, resinous fracture. 

Scammony is often adulterated with various impurities, such 
as sand, ashes, flour, etc., and when free from these is generally 
combined with the expressed juice of the leaves and stems of the 
plant, so as to render it inferior to the true drug obtained as 
above described. The remedy, as found in our shops, is in the 
form of plano-convex cakes, of dark color, unpleasant odor, and 
bitter, disagreeable taste. 

In commerce, there are three varieties of scammony, viz: 
Aleppo, Smyrna, and Montpelier. These are named from the 
place of their exportation. The first-mentioned variety, and 
perhaps the purest, rarely reaches this country. Smyrna scam- 
mony is that which is most frequently met with in America, and 
answers to the above description of the commercial drug. The 
other varieties are said to consist of irregular masses, packed in 
drums, or otherwise for transportation ; and factitious specimens 
are said to have been detected in commerce, bearing very little 
resemblance to the true drug in its essential properties. 

Scammony, as a cathartic, resembles others of the drastic va- 
riety. In full doses, it sometimes acts violently, causing griping 
and watery discharges from the excitement set up by it in the ali- 
mentary mucous membrane. 

The varied degree of action found at different times is doubt- 
less attributable to the difference in susceptibility of the mucous 
membrane to irritating impressions. 



224 ACOLOGY 

Id the dose of five or six (/rains, scam mo ny generally acts freely, 
sometimes violently. Used conjointly with milder cathartics, it 
becomes a useful ingredient in forming a mild and thorough 
purgative. 

( rAMBOGiA —Gamboge. 

The concrete exudation from the broken branches of Garcmia 
ibogia, a native of Siam and Cochin China. Murray, Gra- 
ham and other botanists differ as to the plant from which true 
gamboge is derived. Doubtless several tropical plants yield a 
yellowish fluid resembling gamboge in many respects; hence 
the undetermined botanical origin of this drug. 

Gamboge is in cylindrical pieces several inches in length, one 
or two thick, and hollow in the centre. It is of a dull, yellow- 
ish color, as seen in the roll, but forms a bright yellow powder, 
the odor of which is scarcely perceptible, but a slightly acrid 
taste is perceived after being kept in the mouth for some time. 
It contains a peculiar resin, soluble in alcohol, upon which the 
cathartic property of the drug depends. 

Gamboge is a drastic cathartic, producing, in full doses, nausea 
and sometimes vomiting. It is perhaps less irritating to the 
mucous surface than others of the variety, but acts more upon 
the upper portion of the canal, and hence the nausea produced 
by it. Copious hydragogue catharsis is the result of its action, 
and in large doses griping and other violent and unpleasant 
symptoms attend. Being readily pulverized, it may be given 
with aperients or mild purgatives, the activity of which is in- 
creased, while the harshness of the drug is lessened. This is an 
important ingredient in compound cathartic pills, intended to 
deplete the blood vessels for the indirect influence exerted thereby 
upon dropsical collections, such as anasarca, ascites, etc. 

The full dose of gamboge is about Jive grains, but, in combi- 
nation with rhubard, calomel, or butternut, two grains, repeated 
every three or four hours, will induce copious watery discharges, 
without very great prostration, or other unpleasant symptoms. 

To robust patients, of plethoric habit, gamboge may be given 
alone, in full doses, with great benefit in acute peritonitis. The 



AND THERAPEUTICS. 225 

relaxation and depression consequent upon the nausea produced, 
together with the depletion from the hydragogue effect, make 
gamboge peculiarly applicable in this dangerous inflammation. 

Colocynthis — Colocynth. 

The pulp of the fruit of Cltrullus Colocynthis or Bitter Cu- 
cumber. This is an annual trailing plant, resembling the com- 
mon watermelon, and bears fruit the size of an orange, whose 
medulary portion constitutes the drug under consideration. The 
bitter cucumber is a native of Turkey, and is found in Asia, 
Africa, and islands of the Archipelago. 

As found in the shops, colocynth is in whitish, spongy balls, 
the outer covering or rind having been removed previously to 
drying. It has slight odor, but nauseous, bitter taste. 

The activity depends upon a bitter principle, called colocynthin, 
first obtained by Vauquelin. Colocynth, in substance, may be 
given in the dose of five or six grains; the active principle, colo- 
cynthin, in the dose of about one grain.. 

The officinal extracts afford no advantage in point of concen- 
tration above the pulp in substance, requiring about the same 
dose. As, however, these preparations facilitate the administra- 
tion, they are usually selected when colocynth is required. 
Where remedies in large bulk cannot well be administered, the 
colocynthin may be found preferable to other forms. 

Colocynth is a violent drastic, and when care be not exercised 
in its administration, dangerous inflammation of the inner sur- 
face of the intestines may result from its use. 

The officinal compound cathartic pill of the United States 
Pharmacopoeia takes its promptness and activity from the amount 
of colocynth which enters into its composition, and under proper 
circumstances, answers well as a cathartic. 

The loose manner of using combinations of remedies already 
made into convenient forms, however, often proves extremely in- 
jurious, and as the ingredients, and their proportions to suit any 
particular case, can only be determined at the bedside, it is cer- 
tainly more advantageously done to suit the case under treat- 
ment at the time required for use. 
15 



226 ACOLOGY 

Colocynth answers all the purposes of a hydragogue cathartic, 
producing depletion, counter-irritation and revulsion. 

Elaterium. 

A deposil of the juice which exudes spontaneously from the 
fruit of Momordica Eloterwm, or Squirting Oucumber f & perennial 

trailing plant, native of the south of Europe. 'Hie fruit resem- 
bles the ordinary cucumber of small size, and when mature, 
opens at the stem extremity, ejecting the seeds and juice to a 

considerable distance; hence the name. The juice is obtained by 
slicing the fruit before maturity. It flows without expression, is 
collected, and the sediment or deposit, which forms at the bottom 
of the vessel, constitutes true elaterium. The juice thus ob- 
tained is sometimes evaporated by artificial heat, and in order to 
increase the quantity the fruit is subjected to pressure, thereby 
rendering the imperfect extract still less active. 

The British Pharmacopoeia recognizes, to some extent, these 
imperfect varieties; hence, specimens obtained from London are 
comparatively inactive. 

Elaterium, when pure, is in very thin grayish cakes or frag- 
ments, not thicker than from a sixteenth to the twelfth .of an 
inch. It has very little odor, but an acrid, bitter taste. The 
active principle of the drug resides in a crystalizable substance 
called elaterin, of which pure elaterium contains about forty per 
cent. This substance is soluble in alcohol and has a very bitter 
styptic taste. 

Elaterium is a very powerful hydragogue drastic cathartic, 
and acts principally by its irritating effect upon the mucous 
structure of the intestines. Being much more active, and used 
in smaller quantity than any preceding article of this variety, it 
is preferable in cases of insensibility, in which remedies are with 
difficulty introduced into the stomach, and where the impressi- 
bility of the canal requires more than ordinarily active remedies. 
Care is necessary, however, in its administration under any cir- 
cumstances, lest too active impression be made, and violent 
inflammation should lead to prostration and fatal consequences. 

The dose of commercial elaterium, obtained by evaporating 



AND THERAPEUTICS. 227 

the juice and expressed fluid, is about two grains; of the deposit, 
which subsides from the spontaneous dripping of the fruit, about 
one-eighth of a grain ; and of elaterin, from the sixteenth to the 
twelfth of a grain. 

The active principle being soluble in alcohol, this liquid is a 
suitable menstruum for the administration of elaterium in any 
form. It may be conveniently given in pill, alone or combined, 
with other less active cathartics. 

Oleum Tiglii — Croton Oil. 

The expressed oil from the seeds of Oroton Tiglium, a shrub 
or small tree, native of India. The fruit, containing two or 
three seeds, is the size of a filbert, and also possesses purgative 
properties. The leaves, bark and wood, when chewed, have a 
burning, pungent taste, and irritate the mouth exceedingly. 
When swallowed, they produce the same effect in the stomach and 
bowels, leading to drastic catharsis. 

Croton oil is of bright-yellow color, peculiar odor, and burn- 
ing taste. Its effects upon the mouth are excessively irritating 
and painful. It is more or less so when applied to any part of 
the body, according to the impressibility of tissue with which it 
comes in contact. The skin itself is not exempt from the irritant 
effect, and it is frequently applied to the surface for its local ac- 
tion as a counter-irritant. Upon this property, no doubt, its 
cathartic effect depends, for, when taken into the stomach in a 
fluid form, the mouth, throat, and even the stomach, give evi- 
dences of its local impression upon them. On this account, the 
remedy is generally given in the form of pills. As a cathartic, 
it has been considered the most active and prompt of all the arti- 
cles belonging to this class of remedies. At the same time, the 
quantity in bulk is smaller than that of any other. It is said 
that a drop placed upon the tongue of a comatose subject may 
produce catharsis in an hour, without the effort of swallowing 
required for solid and more bulky prescriptions. 

The oil may be taken in the dose of two or three drops 
for its full cathartic effect. By rubbing it up with crumb of 
bread into a pill, the unpleasant effect upon the mouth and 



228 



ACOKXiV 



throat is avoided, and at the same time its action upon the intes- 
tines seemed. Although a powerful cathartic, there are cases of 
obstinate constipation in which the difficulty is only aggravated 
by it. In intussusception, spasmodic contraction of the bowel 

and circumscribed irri- 

Fig. 20. 

tation or inflammation, 

the local excitement up- 
on which the obstruc- 
tion depends is increased 
by the irritant, and the 
symptoms made more 
violent. 

It would seem that 
this remedy is more par- 
ticularly applicable to 
cases of great insensi- 
bility requiring the re- 
vulsive and depletive 
effect of an irritant hy- 
dragogue. Paralysis 
from apoplexy of the 
brain, and diseases and 
injuries of the medulla 
spinalis, may be prop- 
erly treated in this way. 
By the following plan 
it has been proposed to 
detect croton oil when 
combined with other 
substances : " The sus- 
pected oil is agitated 
with an alcoholic solution of soda or potassa, and the solution, 
having been evaporated, is then saturated with hydrochloric 
or sulphuric acid. If croton oil be present, its acrid principle, 
crolonol, will rise to the surface in the form of an oil, which, 
when applied to the skin, will produce, in three or four hours, 
not only inflammation, but the peculiar eruptive affection excited 
by croton oil." (Maiche.) 




Croton Tiglium. 



AND THERAPEUTICS. 229 

Leptandra — Quiver's Root. 

The root of Leptandra Yirginica, an herbaceous perennial 
plant, found in most parts of the United States east of the Mis- 
sissippi. It has an erect stem rising to the height of three or 
four feet. Leptandra yields its virtues to alcohol and water, 
and, under the name of Culver's Root or Veronica, is used as a 
domestic remedy in portions of Tennessee and Georgia, in the 
form of imperfect tincture. The taste of the root is bitter, some- 
what acrid, and has a feeble, not very disagreeable odor. 

The virtues of the root are said to reside in a crystal izable, 
resinous substance, improperly called leptandrin. Leptandra is 
a drastic cathartic in full doses, and has been used as a chola- 
gogue. That it has any more influence upon the liver, however, 
than other cathartics acting upon upper portions of the intes- 
tines, is not at all certain. Owing to the violence of its action, 
there might be found much more appropriate hepatic excitants, 
should it possess this property. The dose of the powdered root, 
as a cathartic, is about thirty grains; of the impure resin, about 
two grains, which may be made into pills and taken without 
inconvenience. * 

CLASS III. 

GASTRIC OR DIGESTIVE TONICS. 

Tonic, when applied to the action of a remedy, signifies the 
power of giving permanent vigor to the organ or tissue upon 
which it acts; and in order to a rational and practical under- 
standing of the term, the name of such structure should always 
be coupled with it. There is, perhaps, no such thing as a gen- 
eral direct tonic, acting upon several or all dissimilar tissues at 
the same time. It is nevertheless true, that general debility may 
be relieved by one remedy, for all parts become inactive from a 
want of power in any controlling organ of the body, and what- 
ever gives energy to that organ indirectly modifies the state of all 
others, and gives general activity. For example, debility of the 
nervous centres entails the same on the whole animal economy, 
because a proper amount of nervous influence is necessary to the 



230 ACOLOCY 

vigor of every part. Under such circumstances, tonics, calctM 
lated to restore nervous energy, Beera to be general in their effect, 
yet their action is exerted upon the nervous system alone. The 
same may be said of the class under consideration. Universal 

inactivity is the result of debility in the digestive organs. The 
blood becomes impoverished from failure of the digestive appa- 
ratus to manufacture from food the material by which this fluid 
can furnish nourishment neeessary to the support and invigora- 
tion of every structure. Then, to save confusion, and to bring 
about important practical results, the classes of tonics, as well as 
all others mentioned in this work, are named with reference to 
their direct physiological action upon the particular parts im- 
pressed. 

It is not unusual to consider blood-tonics in connection with 
those acting on the digestive organs, since both tend to restore 
deficient ingredients in the circulation. It must be remem- 
bered, however, that while the former do so by affording directly 
the required material, the latter restore the circulating fluid to 
its normal condition, indirectly, by promoting the digestive pro- 
cess. Gastric or digestive tonics, then, are understood to be 
remedies which act directly upon the stomach or other digestive 
organs, giving permanent vigor or tone. 

Some doubt exists as to the manner in which the functions of 
the stomach are affected by the use of these tonics. We know 
that particular influences are concerned in chymification, and it 
is not always clear whether one or all have failed in a given case 
of imperfect gastric digestion. The solvent fluid and contrac- 
tion of the viscus upon its contents are indispensable to the proper 
preparation of the food, and it is not always certain, in imperfect 
chymification, which of these is deficient. General symptoms, 
however, attending cases in which ordinary digestive bitter ton- 
ics are serviceable, lead to the conclusion that imperfect muscular 
contraction of the stomach is a serious difficulty. It is some- 
times plainly discoverable in such cases, that a general want of 
peristaltic motion in the whole alimentary canal exists. The 
food finds its way slowly from the stomach into the intestines, 
and equally tardy is the fecal portion in traversing the entire 



AND THERAPEUTICS. 231 

canal. It is also clear in other cases, where meats, and other 
articles of solid food, pass from the stomach in an imperfectly 
chymified state, that the solvent has not been secreted in 
sufficient quantity. It is believed that the correction of both 
difficulties is effected by gastric tonics, and in some instances, 
perhaps, by the same remedy. It is not, however, by any means 
acting the part of wisdom to drug all dyspeptics with bitter 
tonics; for the most deplorable cases of dyspepsia are only ag- 
gravated by the means calculated to excite this organ in any 
way. Chronic inflammation of the mucous coat leads to the 
most distressing form of indigestion, by the arrest of the secre- 
tions, and the irregular spasmodic contractions induced by the 
contact of solid food with the irritable inner surface of the vis- 
cus. Under such circumstances, bitter tonics are not only not 
called for, but prove decidedly injurious. It is well known that 
the gastric juice is indispensable to the proper change of food in 
the stomach, and it must be understood from the foregoing, that 
bitter tonics certainly act directly upon the stomach, and proba- 
bly in such manner as to give increased vigor, not only to the 
muscular coat, but also to the parts concerned in the manufac- 
ture of the gastric fluid. Indeed, it is not improbable that a 
want of this indispensable fluid may lead to the symptoms at- 
tending cases of ordinary inactivity of the stomach. And it is 
by no means unreasonable to conclude that a sufficiency of it 
may afford the organ its natural and accustomed stimulus, there- 
by restoring that activity necessary for the proper kneading of 
the food. So that, after all, the theory attributing the good ef- 
fects of gastric tonics to their direct action upon the follicles 
affording the gastric juice, is equally, if not more plausible than 
any other. Indeed, the fact that the introduction of pepsin, an 
essential ingredient of the gastric fluid, affords temporary diges- 
tion in ordinary inactivity, goes very far towards establishing its 
truth. 

In addition to the pharmacological digestive tonics, which, as 
we have said, promote the function by their direct stimulus to the 
muscular coat, or to the parts producing the gastric juice, or 
both, there are mechanical means by which digestion is greatly 



232 ACOLOGY 

facilitated. The agitation of any organ is likely to increase its 
activity. The peristaltic movement of the whole alimentary 

canal becomes sluggish from sedentary habit of life, and it would 
seem that even the secretions, poured out upon the mucous sur- 
face, (perhaps the gastric and pancreatic fluids included) and the 
exhalations into the canal are lessened by the want of proper 
bodily exercise. This is proven by the hardened and dry lieces 
discharged under such circumstances. 

Exercise is, therefore, an important means by which the 
therapeutist seeks to restore the functions of these organs when 
deranged. Certain manipulations connected with the region of 
the stomacli come properly under this head, and, when carefully 
conducted, may prove useful. The system of punching the epi- 
gastrum, however, once so extensively practiced by a set of em- 
pirics, mentioned under the head of enteric excitants, was used 
without tfny knowledge of the true source of trouble, and too 
indiscriminately, to prove otherwise than injurious in many cases. 
General exercise, to be effectual, should be practiced, contrary to 
the opinion of some, while the stomach is comparatively empty. 
It is a pretty well established physiological fact, that exercise of 
mind or body, or the indulgence in sleep soon after food has 
been taken into the stomach, retards and interferes with the pro- 
cess of digestion. Composure or very gentle exercise for an hour 
or more is decidedly preferable. Exercise, which should never 
be so excessive as to cause very great fatigue, is better taken in 
the early part of the day, before the first meal, and late in the 
afternoon. Walking in the open air, and horseback riding, are 
perhaps the best modes. These give, not only the agitation 
necessary to excite the stomach and other organs to increased 
activity, but afford new T objects for contemplation, thereby reliev- 
ing the mind from ennui and tormenting imaginations. 

Another variety of mechanical tonics, which, though purely 
of this character, are subject to pharmaceutic preparation, and 
therefore considered under the head of pharmacological remedies. 
These are composed of rough substances, such as charcoal, etc., 
which titilatcthe surface of the stomach, and though their action 
is local, having no elective tendency to any particular structure, 
they excite the parts with which they come in contact. 



AND THERAPEUTICS. 233 

Cibus — Food. 

Food, though not, strictly speaking, a tonic, has been called 
the "great tonic/' or invigorator, and has very much to do in 
the production and cure of the condition in which digestive ton- 
ics are useful. Food itself leads to embarrassment of the di*2;es- 
tive organs, not only from the improper quantity and quality, 
but the manner of its preparation. It is notorious that an over- 
quantity taxes the organs beyond their - capacity, and not only 
leaves them enfeebled by over-action, but also embarrasses the 
whole canal with that portion that could not be digested. Thi s 
is a prolific cause of indigestion, a serious difficulty in the way 
of effecting a cure, and should be kept in view in our attempts 
to prevent, as well as relieve, this troublesome affection. The 
quality of food, with respect to the ease with which it is di- 
gested, is considered equally important. The necessary quantity, 
indeed, can be determined alone by its digestible quality. Some 
descriptions of food can be digested in double the quantity in 
which other varieties prove embarrassing to, and pass undigested 
from, the stomach. This difference does not depend at all upon 
the difference in the amount of nutriment each may contain. 
Some of the most nutritious articles are most, easily digested, 
and vice versa. Experiments have determined the amount and 
variety of nutrient principles contained in the several articles 
of food, and experience in their use has led to a knowledge of 
their digestible character. The several articles differ from 
each other, not only in these respects, but in, their local effects 
upon the surface of the alimentary canal. While some are bland, 
soothing and unirritating, others are exciting, rough and injuri- 
ous when coming in contact with an irritable or inflamed mucous 
membrane. This difficulty, however, to a large extent, may be 
obviated by the culinary process.es to which they may be sub- 
jected. The two main divisions of food, recognized in culinary 
operations, are solid and liquid. Each of these forms may be 
made either of nutritious or meagre articles of diet. That is to 
say, oleaginous, albuminous and saccharine substances may be 
used in fluid forms, such as soup, broth, milk, chocolate, etc. In 



234 ACOLOGV 

meats, bread, cheese, butter, etc.; the same tissue-making and 
calorific ingredients exist. Fluid preparations arc not only more 

easily, but more speedily appropriated, and are hence selected 
in eases of great prostration, emaciation and anemia. Milk, 
which contains all the necessary ingredients for the nourishment 
of every structure in the body, is more digestible and nourishing 
than other fluid or solid food, and may be used exclusively, with 
benefit, in cases taking no exercise, and having imperfect diges- 
tion, with great want of nourishment. 

Some of the nutrient principles contained in meat are sepa- 
rated from the coarser portion in the form of soup extract, essence, 
beef tea, etc. In this way food is not only made less consistent, 
but more concentrated, so that the same amount of nourishment 
is obtained from much less bulk, and with less tax upon the di- 
gestive organs. A concentrated preparation of meat is found in 
market in the solid form, and may readily be prepared for use 
by dissolving it in hot water. This preparation, as generally 
manufactured, however, is deprived of albumen and fat, useful 
elements in food, and may be substituted, profitably, by an ex- 
temporaneous preparation, made by cutting in small pieces a 
pound of beef, and, after putting it in a bottle, boil in a vessel 
of water a few hours ; then gently compress the meat, pour off 
the extract and season to the taste. 

Milk, soup, and other fluid preparations of food, are not only 
desirable on account of the less tax upon the digestive organs in 
preparing them for assimilation, but, irom the small amount of 
effete particles left in the bowels, they are indispensable in enter- 
itis, and diseases in which there is even a tendency to irritation 
of the alimentary mucous membrane, such as typhoid fever, etc. 
Indeed, when food is taken in the fluid form alone, the amount 
of fecal matter passing through the bowels is small, and alvine 
evacuations are seldom necessary. When solid articles, particu- 
larly meat, are used in the diseases mentioned, great injury may 
result, not only on account of the rough substances in contact 
with the inflamed and irritable surface, but from the frequent 
disturbance in their evacuation. 

The flour of meat, noticed under the head of " ha^matinics," on 



ANT) THERAPEUTICS. 235 

page 149, unlike extracts, contains the entire elements, and is 
preferable for the purpose of thorough invigoration. This, with 
farinaceous and milk diet, will restore general vigor after pros- 
trating disease much more certainly than ferruginous, bitter and 
other tonics. Indeed, when food can be digested and appropri- 
ated, no digestive tonic is necessary. Gastric tonics are called 
for only when the stomach needs artificial energy by which it 
may be enabled to do the work. This, however, is less frequently 
the case than is generally supposed. 

Wholesome food is understood to be the kind most appropri- 
ate in health. That only is wholesome in disease which suits 
the particular case, and no general rule can be made applicable 
to all. 

In addition to the suggestions above, touching fluid and nu- 
tritious diet, it may be stated that the existence of inflammatory 
conditions forbids the use of food abounding in albumen, fibrin, 
and fats. In such cases the plasma of the blood and heat of 
the body require to be reduced, and their increase, by the use of 
such articles of food, aggravates the prevailing inflammation. 
While this is a rule that should be observed strictly during the 
first stages of acute inflammations, there arrives a period in their 
progress when the opposite becomes necessary. The common 
sense of practitioners must determine the point when the waning 
energies of the system require the change from meagre to nutri- 
tious and invigorating food. That stage' is not always marked 
by depressed state of the circulation, pale and cool skin. The 
pulsation often becomes more frequent, accompanied by a flushed 
face, and thirst. These are the usual symptoms found in ady- 
namic fevers, and they increase under the use of scant or poor 
diet. In health, wholesome diet consists of such articles as con- 
tain the ingredients necessary to replenish the waste of tissue, 
and keep up the necessary heat. For this purpose, in violent 
disease, milk is most desirable, containing all essential ingredients 
and at the same time easily digested. Under such circumstances, 
nourishing and digestible articles are more pressingly demanded, 
and in a form to insure their ready preparation and transmission 
into the circulatory system. Like the fallacy of purging away 



236 ACOLOGY 

the unhealthy secretions of the bowels in enteritis, the practice 
of combating the irritable, frequent pulse and ho1 skin, in low 
forms of fever, by depletion and poor diet, (ails to effect the ob- 
ject, and hasten- a fatal termination. 

Gastric Juice — Solvent of Food. 

This is a liquid secretion of follicles connected with the gastric 
mucoUs membrane of man and inferior animals, in whom diges- 
tion is promoted by its solvent power on certain nitrogenous 

articles of food. The fluid affords about one and a quarter per 
cent, of pepsin, the active principle upon which its virtue de- 
pends. It may be obtained from the stomach of animals recently 

killed, and by filtering deprived of mucus and aliment which 
may be found mixed with it. 

Reference has already been made to the different pathological 
conditions found in dyspepsia or indigestion. It is there inti- 
mated that deficiency of gastric fluid exists in each of the oppo- 
site states of the stomach, irritability and inactivity. Lesion of 
the mucous membrane will certainly interfere with its secretion, 
while lethargy of the organ may occur for the want of this 
natural stimulus; and the secretion may fail also from mere 
gastric debility. So, it will be perceived, there is uncertainty 
and difficulty in determining the primary disturbance in these 
respects. Moreover, when gastric irritation exists, the digestive 
process may be interfered with by unusually violent peristaltic 
contraction, even with a supply of gastric fluid, giving great 
pain and hurrying the unprepared contents into the small intes- 
tines. A normal condition of the two influences, contraction 
and solvent fluid, is then evidently necessary to perfect chymifi- 
cation. The latter is doubtless essential, and must be artificially 
supplied when deficient. 

In order to prevent the spasmodic contraction and consequent 
unpleasant symptoms, and also aggravation of the local disease 
itself, in gastric irritation, confinement to bland, unirritating 
fluid diet is of the highest importance. 

It is not contended that pepsin will tend in the least to coun- 
teract, directly, local disease of the stonVach, but is intended only 



, AND THERAPEUTICS. 237 

to promote digestion for the time. Other means, sueh as eoun- 
ter-irritants externally, bland demulcent drinks, catheretics, etc., 
must be instituted to relieve the chronic inflammation or ulcera- 
tion, before digestion can take place even with this artificial sol- 
vent of the food. 

Gastric juice as obtained from the stomach, and filtered as 
before stated, is rarely given in this form, as it cannot be pre- 
served for any length of time Half a fluidounce, taken just 
after a meal, however, will answer the purpose of a solvent in 
the digestion of substances containing fibrin and albumen. There 
are preparations of this fluid in which the active principle is 
afforded in a more concentrated form. 

Rennet is an infusion or wine made of the dried stomach of 
animals, and contains pepsin in solution. It is prepared by 
macerating the gently-washed stomach of the pig, sheep or calf 
in wine or water. When of ordinary activity, a teaspoonful of 
rennet will curdle a pint of milk in five minutes. Rennet, to 
be effectual, must be recently prepared and kept secluded from 
the air. In order to its ready preparation when required, the 
stomach of a calf, after being cleansed of its contents without 
interfering with the secretion attached to the mucous surface, 
may he dried and preserved for use. It should be given in the 
dose of a teaspoonful, just before or after each meal, when the 
remedy is required to promote digestion. 

Pepsin — Pepsine — is the active or solvent principle upon which 
the virtues of gastric juice and rennet depend. It may be pre- 
pared from rennet made of the dried stomach, or an infusion of 
the mucous membrane alone, by precipitating the pepsin with 
acetate of lead. The pepsin and oxide of lead thus precipitated 
are mixed with water, and the lead precipitated with sulphureted 
hydrogen, leaving the pepsin in solution. This is evaporated to 
the consistence of syrup by a heat not above 100° Fahr., and 
made solid by the addition of starch. Fifteen grains of pepsin 
thus prepared is the proper quantity to be taken immediately 
before or after each meal, in order to temporary digestion, when 
the process fails from deficiency of gastric fluid'. This amount, 
in half a fluidounce of water, will dissolve eighty grains of finely 
chopped meat or white of egg. 



238 ACOLOGY 

Ordinary bitter tonics are not applicable in an irritable state 
of the stomach, and, to say the most for them, do do good under 

such circumstances. The action had by them certainly tends to- 
ward excitement of the stomach, and when this is already exces- 
sive, nothing but evil can result from increasing it. It is only, 
then, in eases of indigestion, dependent upon inactivity of the 
stomach, but without lesion of the mucous membranoe, that bit- 
ter tonics are useful. Under such circumstances, a sluggish con- 
dition of the whole canal is generally found, and, possibly, to 
some extent dependent on a want of the accustomed stimulus 
from the seeretions, gastric juice, pancreatic fluid and bile. 

Catalogue of Gastric Tonics. 

Calumba, Quassia, 

Frasera, Coptis, 

Gentiana, Sabbatia, 

Gentiana Catesbaei, Acida Minerales. 

Calumba — Columbo. 

The root of Cocculus Palmatus, a twining plant with peren- 
nial root, and native of Mosambique. The stem is near half an 
inch thick, proceeding from a caudex w r hich sends off into the 
earth several tubers, one or tw r o inches thick. The root is gath- 
ered in March, and being cut into transverse slices of half an 
inch thick, is dried in the shade. The pieces, when dry, have a 
brownish, wrinkled epidermis surrounding the external firm cor- 
tical and internal medullary, or spongy portions. The cut sur- 
face has a bright yellowish color, and the whole root has a not 
very nnpleasant taste. The medicinal virtues of the drug are 
supposed to reside in two active principles, columbin and berber- 
ina. The latter is thought to be identical with that obtained 
from frasera. 

Columbo is a mild, unirritating tonic, and was once supposed 
to possess slightly laxative property. In debility of the stom- 
ach from exhausting disease, or in ordinary dyspepsia, columbo 
is a useful tonic, when such remedies are called for. 



AND THERAPEUTICS. 



239 



Investigations and experiments have not given satisfactory ex- 
planations of the modus operandi of this and other bitter tonics, 
in restoring the function of digestion when impaired. 



Fig. 21. 




Coccidus palmatus. 
a. Male flowers, b. Calx. c. Stamen, d. Petal, e. Bract. 



As has already been said in our general remarks upon this 
class, it is not always positively known what radical difficulty 
exists in cases where such tonics are useful ; whether the defi- 
ciency of gastric fluid, or inactivity of the muscular coat of the 
stomach alone, disturbs the function primarily. It is not im- 
probable that the difficulty at first consists of imperfect secretion 



240 lOOLOOT 

of gastric juice, and the sluggish action of the organ results 
from a want of this natural stimulus. II* this conjecture be 
correct, which is not by any means an established fact, the sole 

benefit derived from this variety of tonics probably depends 
upon the increase given to this secretion. 

Pulverized columbo may be used in substance in the dote of 
twenty grains, but is more conveniently administered in some fluid 
form of preparation. 

Infusum ( '<>/uiiib<r — Infusion of Columbo — is prepared by ad- 
ding half a drachm of the coarsely pulverized root to a pint of 
hot water. About four ounce* of the clear infusion may be taken 
three times a day. 

The tincture and extract are officinal, but have no practical 
advantage over the infusion, except that the latter becomes sour 
if kept for some time, and therefore has to be prepared in quan- 
tity suffieient only for a few days. 

Columbo is often combined with other tonics, aromatics, etc. 

Frasera — American Columbo. 

The root of Frasera Walteri, an indigenous plant, with trien- 
nial root, found abundantly in Aarkansas, Missouri, and other 
Southern States. 

This plant differs materially from the cocculus palmatus, or 
true columbo, of Mosambique. While the latter has a twining 
stem, extending to considerable distance onthe ground, or cling- 
ing to branches of contiguous trees, the frasera has an erect, solid, 
round stem, rising to the height of six or eight feet. The leaves 
are arranged in whorls, with regularly diminished intervals, to- 
ward the summit. The stem and flowers appear only the third 
year. Previously to this, the radical leaves, which are broad, 
lie upon the ground. From these facts, it has been supposed 
that perfection of the root has not been attained until this trien- 
nial development has been arrived at. 

Consequently, during the flowering season the root is dug, cut 
into transverse slices, the fourth of an inch thick, dried in the 
shade, and preserved for use. 



AND THERAPEUTICS. 



241 



This root, when dried, resembles the Mosambique columbo in 
several particulars. The pieces are somewhat smaller, but in gen- 
eral appearance, color and taste, there is a striking resemblance. 

Like the true co- 
lumbo, frasera yields 
its virtues to water and 
alcohol, and is subject 
to the same forms of 
preparation. The 
strength being inferior, 
from one-third to one- 
half more of frasera is 
required for a dose. 

The medicinal pro- 
perties also resemble 
those of columbo so far 
as its tonic effect is con- 
cerned, but, from re- 
ports of its action, has 
perhaps more laxative 
tendency. There is no 
doubt, however, that in 
proper quantity to ef- 
fect tonic action upon 
the stomach, no un- 
pleasant disturbance of 
the bowels will be 
brought about, and 
perhaps, when tested 
more systematically 
and thoroughly, may 
be made to supplant 
the true columbo, at 
least in the United 
States, where it may be obtained at less expense. 

Being subject to the same forms of preparation, we refer the 
reader to the preparations of columbo for those of frasera. 
16 




Frasera Walteri. 



242 



APOLOGY 



(J KN'TI AN A — (u, if tan. 

The pool of Gentiana Lutea,, or yellcnc gentian, an annual plant, 
three or four feel high, with perennial root, and native <»t' the 
Alps, and other mountains of Europe. The root, which is the 
only part used medicinally, is from half an inch to one inch 
thick. As found in the shops, it is of a brownish color, wrin- 
kled, and of a sweetish bitter taste. The larger portions of the 
root are split longitudinally to facilitate the drying. 

Gentian is less 
bitter to the taste 
than most of the 
bitter tonics. It 
is said to contain 
sugar; hence the 
taste, and readi- 
ness with which 
watery prepar- 
ations fermen.t. 
The solid and 
fluid extracts are 
officinal, and in 
these forms the 
drug is readily 
administered. 

Infusum Gentianw — Infusion of Gentian — is the form in which 
it is most frequently used, but, owing to the fact of its becoming 
sour, must be prepared afresh every two or three days. It is fre- 
quently combined with other gastric tonics, particularly columbo, 
in the form of infusion. 

Thirty grains each of pulverized columbo and gentian to 
the pint of boiling water makes one of the most agreeable and 
useful tonics. This quantity is sufficient for two days use. The 
infusion should be prepared in the evening, and after macerating 
for twelve hours, the clear infusion may be poured off, and used 
in the dose of two or three fluidounces three times a day. 

An indigenous plant called Blue Gentian, found abundantly 




Gentiana lutea. 



AND THERAPEUTICS. 243 

in the low lands of North and South Carol inas, resembles, in 
many respects, the officinal gentian, and may be with propriety 
substituted for it. 

Geniiana Catesbcei — Blue Gentian — is the botanical name of 
the plant referred to. There are several other species of the 
genus Geniiana which are mentioned by botanists. None other, 
however, has attracted attention as a medicinal plant. 

The blue gentian is subject to the same forms of preparation 
and doses as those mentioned for the foreign drug. 

Tinetura Gentiance Composita — Compound Tincture of Gentian 
This is an officinal preparation of the root, and contains the 
aromatic principle of cardamom, the exciting effect of which 
upon the stomach gives increased activity at once to the powers 
of digestion. The taste is also improved by this addition, ren- 
dering the tincture more acceptable and grateful. 

In the dose of two fluidrachms, the preparation affords the tonic 
and exciting effects desirable in dyspepsia or temporary inactivity 
of the stomach. 

Quassia. 

The wood of Quassia excelsa, a tall tree, native of the West 
Indies, and found in the shops in the form of chips or rasp- 
ings, being difficult to pulverize. Different species of the quassia 
have been described by botanists, and the drug from more, than 
one of them has beeu used. 

Quassia Amara, a small tree, native of Surinam, afforded the 
quassia of commerce for a long time after its discovery as a rem- 
edy. This plant, it is said, is also found in some parts of the 
West Indies, and although thought to supply none of the quassia 
now obtained for market, may yet afford a portion of that ship- 
ped from these islands. In their medicinal virtues, no important 
difference has been discovered in the product of the two vari- 
eties. 

Quassia is intensely bitter, is of a yellowish color, inodorous, 
and yields its virtues readily to water and alcohol. So promptly 
is the active principle dissolved in water, that a block of the 
wood excavated in the form of a gourd will speedily impregnate 



'2 1-1 ECOLOGY 

the water used from it in drinking, and in this way, It is said, 
the remedy is sometimes taken. 

Tindtura Quassia — Tinctwn of Quassia — is an officinal prepa- 
ration, but, unless the effects of alcohol itself be desirable, this 
is not an appropriate form, owing to the large amount of spirit 
required in a full dose of the remedy, which is about three fluid- 
rachms. 

Infusum Quassias — Infusion of Quassia — is the most conveni- 
ent and useful preparation of the drug. It may be readily pre- 
pared, either with cold or warm water, as required for use. 

Quassia is a pure, hitter tonic, without any astringent or stim- 
ulating property which would make it objectionable in ordinary 
cases of indigestion. Sixty grains of the rasped or chipped quassia 
wood may be macerated in a pint of water for a few hours, and 
affords a sufficient quantity for tiro (tans' 1 use. 

COPTIS — ; Goldthread. 

The root of Coptis Trifolia, a small plant, with perennial, 
slender, yellowish roots, proceeding from a caudex at the surface 
of the earth, from which the leaves and flower-stems arise. 

The goldthread is a native of the northern mountainous por- 
tions of the United States and Canada. The root alone is med- 
icinal, and, as found in the shops, consists of long, slender fibres 
matted together, and frequently intermixed with portions of the 
stems and leaves. It is inodorous, exceedingly bitter, and of an 
orange-yellow color, tinging the saliva when chewed, and giving 
to water or alcohol, when macerated in it, the characteristic hue 
of the root. Coptis readily yields its virtues to water and alcohol, 
and is usually administered in the form of tincture or infusion. 

As a digestive tonic, this remedy r ranks with quassia as an ex- 
cellent remedy in debility of the digestive organs, the result 
of prostrating disease, or of functional derangement of the 
stomach from other cause. It is not particularly exciting, so as 
materially to interfere, even when slight local irritation of the 
mucous surface of the organ exists. 

An Infusion, made with thirty grains of the dried root to a 
pint of water, and macerated a few hours, is a convenient form 



AND THERAPEUTICS. 245 

of administration. The dose of this is about three fluidounces, 
half an hoar before each meal. 

The Tincture, made with a troyounce of the root to a pint of 
diluted alcohol, may be used in the dose of one or two fluidrachms, 
throe times a day. 

Sabbatia — American Centaury. 

The whole herb of Sabbatia Angularis, an annual herbaceous 
plant, one or two feet high, found throughout the Southern 
States. It is collected during the flowering season and dried in 
the shade. Centaury has the usual bitter taste of other bitter 
vegetable tonics, and, having similar medicinal properties, may 
be used for the same purposes. 

Infusion, made by pouring a pint of hot water on a troyounce of 
the herb, though not officinal, is an effective preparation, and may 
be conveniently used in the dose of three fluidounces, three times 
a day. 

Decoction, a somewhat more concentrated form, is prepared by 
boiling in water the same proportion of the drug used for infusion 
and may be given in the dose of two fluidounces, three times a day. 

This, like other bitter tonics, is sometimes used to advantage 
in feeble digestion, whether as the result of ordinary disease, or 
in derangement of this function from primary disturbance in the 
organ itself. In the slow recovery which sometimes follows vio- 
lent attacks of remittent, or adynamic fever, tonics of this kind 
increase the appetite and promote the function of digestion. 
Such remedies have been used with the view of counteracting 
the deranged condition upon which intermittent and remittent 
fevers depend, but, inasmuch. as the nervous centres are primarily 
disturbed in such cases, it is not likely that digestive tonics will 
be of any service whatever for this purpose. 

Acida Minerales — Mineral Acids. 

Under this head we introduce another variety of digestive 
tonics, differing widely, in their sensible properties, and other 
respects, from bitter tonics, and yet are applicable in somewhat 
similar forms of gastric debility. These acids, owing to their 



246 ACOLO*. 

corrosive character, arc never used internally except when 
largely diluted, and, even then, the teeth are liable to injury* 
unless due caution be exercised. 

They play an important part in therapeutics, and produce their 

eil'ccts upon the digestive organs in a manner not very satisfac- 
torily understood. Not only do they have tonic action upon the 
stomach, but the liver, in a state of debility, is often favorably 
affected by them. Whether the functional modification is made 
by direct influence upon the latter organ, or through the change 
wrought in the former, is a question about which all are not very 
well satisfied. It is known that these organs sympathize greatly 
with each other. This is plainly discovered in the effects of dis- 
ease in the stomach, upon the function of the liver and vice versa. 
For example, when chronic gastric inflammation exists, the liver 
fails to secrete the usual quantity of bile, and is the subject of 
more or less organic derangement, such as congestion, etc. The 
same may be said of primary disturbance of the liver upon func- 
tions of the stomach. 

So marked is this sympathy between the two organs, that it is 
difficult to determine, from the symptoms present in derange- 
ment of these organs, which of the two, is primarily diseased. 
A history of the case, with physical and other modes of 
critical examination, often fails to make certain the starting 
point of the derangement. With this doubt in diagnosis, there 
can, of course, be no certainty of permanent success in the use 
of remedies directed to the relief of either organ alone, unless 
the remedy selected should exert its influence upon both at the 
same time. 

It is pretty satisfactorily ascertained that some, at least, of the 
mineral acids do this, and are therefore highly prized in the treat- 
ment of chronic inactivity of the chylopoietic viscera, where no 
inflammatory condition exists, or when such state has been meas- 
urably relieved. 

That certain of these acids are better adapted to the treatment 
of hepatic derangement than others seems probable, and are 
hence used internally and epidermically, when prominent symp- 
toms of such exist. On the other hand, while all are believed 



AND THERAPEUTICS. 247 

to possess gastric tonic properties, sulphuric; acid, as will be seen 
below, seems to be especially appropriate in certain forms of gas- 
tric debility. 

From this it would appear that, while all these acids act as 
tonics to the stomach, a portion of them only are relied upon as 
being directly invigorating to the liver. 

Acidum Sidphuricum — Sulphuric Acid. This is a colorless, in- 
odorous, heavy liquid. (Spec. grav. 1.843.) It has an oleagin- 
ous appearance when agitated, or in being poured from a vessel, 
and is excessively corrosive on account of the great affinity it 
has for water. In medicine, it is used only in diluted form, in 
the dose of one drop. 

Acidum Sidphuricum Aromaticum — Aromatic Sulphuric Acid — 
known also as Elixir of Vitriol, is the form in which sulphuric 
acid is administered. In this preparation the acid is diluted so 
that fifteen drops, the ordinary dose, contains less than one minim 
of the pure acid. The ginger and cinnamon entering into this 
preparation gives it a pleasant, aromatic odor and agreeable 
taste. These exciting ingredients, not only render the prepara- 
tion more grateful, but add materially to the invigorating effects 
of the acid, when used in gastric debility. 

Elixir of vitriol is more particularly useful in the debility fol- 
lowing acute diseases in which the appetite is depraved, and the 
required amount of food is not likely to be taken. Another im- 
portant action is that of modifying the fluids of the body, or the 
tissues through which they pass, so that hemorrhagic and per- 
spiratory tendencies are very much relieved by its use. The lat- 
ter, particularly, often proves embarrassing in the treatment of 
adynamic fevers, phthisis, and other diseases in which great pros- 
tration exists, and requires some counteracting agent. 

Acidum Nitricum — Nitric Acid. This acid, called sometimes 
aqua fortis, is a thin, colorless liquid, (Spec. grav. 1.42) more 
volatile than sulphuric, emitting irritating vapor, which, when 
respired, gives rise to an unpleasant sensation in the respiratory 
organs. It may be given in the dose of two or three drops diluted 
with three or four ounces of water. A diluted form is kept for 
internal use, and is administered in the dose of half afluidrachm. 



248 AC0L0G1 

Nitric acid is a digestive tonic, giving energy to the" stomach 
when depressed from any cause, except acute inflammation of the 

mucous surface, and even then may not always be objectionable, 
if* sufficiently diluted. This acid, though powerfully corrosive 
when concentrated, is not even irritating, if dilated to the strength 
of an ordinary acid drink. The same may be said of the other 
mineral acids used as gastric tonics. In functional debility of 
the liver, connected with indigestion, it is useful. Whether anv 
direct influence be exercised upon this organ, or through the im- 
pression made upon the stomach, or whether, if not through 
this means, the increased acid quality of the blood may be suffi- 
cient to excite the function under certain circumstances, is not 
very well determined. As already stated, such an intimate sym- 
pathetic connection exists between the stomach and liver, that it 
is exceedingly difficult sometimes to tell what organ is at fault, 
when the functions of both are deranged, and therefore in the 
rather empirical use of remedies found beneficial from experi- 
ence, it is difficult to determine upon which organ the action 
is exerted, to say nothing of its modus operandi. 

Acidum Muriaticum — Muriatic Acid. This is a solution of 
hydrochloric acid gas in water, and is of the specific gravity of 
1.20. It is also called by chemists hydrochloric and chlorohydric 
acid. The pure acid is colorless, but as found in commerce, has 
a greenish yellow tinge. Like the other mineral acids, it is cor- 
rosive, and is much more volatile than nitric acid — the vapor, 
when inhaled, causing a sense of suffocation, and excessive irri- 
tation of the respiratory organs. 

As a digestive tonic, in the dose of five or six drops, the usual 
effects of nitric acid upon the functions of the stomach and liver 
may be expected. Its antiseptic property renders it more useful 
in malignant diseases, in which an unhealthy condition of the 
fluids exists, particularly in the alimentary canal. The peculiar 
styptic effects of this acid give it advantages over others as a 
tonic in hemorrhagic conditions. It is not only tonic and styptic 
in hemorrhage from debility and relaxation of the alimentary 
mucous membrane, but for hematuria, etc., in which the remedy 
affects the bleeding only through the circulation. For these 



AND THERAPEUTICS. 249 

purposes, it is more advantageously used in combination with 
iron, in the form of 

Tinctura Ferri Muriatis — Muriated Tincture of Iron. In this 
form the acid is more generally used for the purposes mentioned, 
and, even when intended to invigorate the functions of digestion 
alone, this preparation is not particularly objectionable. It is 
thought to have a decidedly tonic effect upon the urinary organs 
when in a state of chronic irritation and debility. Fifteen or 
twenty drops three times a day, is the manner of administering 
it for these purposes. 

As a digestive tonic, particularly when connected with con- 
stantly deranged function of the liver for a length of time, a 
combination of muriatic and nitric acids is preferred to any tonic 
of this kind. 

Acidum Nitromuriaticum — Nitromuriatic Acid — Aqua Regia — 
as it has been called, from the solvent power it exerts upon gold, 
combines those properties of the mineral acids by which chronic 
disturbance of the liver, stomach and other digestive organs is 
relieved. It is simply the admixture of the two acids in the 
proportion of one of nitric to two of muriatic acid. 

About four drops is the quantity to be given three times a day, 
largely diluted with water, and otherwise guarding against injury 
to the teeth. The epidermic application, by sponging and bath, 
in connection with its internal use, is practiced when it is desir- 
able to impress the liver particularly and thoroughly. For ex- 
ternal-application in this way, a bath in the strength of about 
two fluidounces of the acid to a gallon of water is made and 
placed in a deep, narrow vessel, in which the feet and legs are 
exposed to its action for half an hour every day, and the body 
may be sponged at the same time with the preparation. 

Other excitants, not properly belonging to the sub-order of 
vital agents, may be mentioned. 

Rough substances, coming in contact with the surface of the 
stomach, excite not only the mucous membrane and the gastric 
follicles connected with it, but also the muscular coat of the vis- 
cus, through the titillation thus communicated. This action fills 
4;he indications present in an ordinary case of indigestion from 



250 iCOLOOl 

Lethargy of the stomach without irritation, and although not 
coming properly under the sub-order of vital remedies, it is 
thought proper to notice them in this place. It has been stated, 
in relation to this variety of remedies as cathartics, that increased 
activity is given to the whole alimentary canal by such mechan- 
ical means, and that improved digestion and aperient movement 
arc the results. It is a fact that constipation is a common at- 
tendant of indigestion, from the cause just mentioned, making 
these substances particularly useful. 

Carbo Ligni — Charcoal — when coarsely pulverized and taken 
into the stomach titillates the surface, and brings about the actions 
above described. In connection with some gastric stimulant, 
ginger, cinnamon, cloves, etc., pulverized charcoal is a favorite 
prescription with some practitioners in the treatment of dys- 
pepsia. 

Bran, used separately or in the form of bread made of un- 
bolted flour, has a similar action — exciting, mechanically, the 
surface by contact of its coarse and rough particles. 

Graham Bread, is of this kind, and is used almost exclusively 
by some dyspeptics, in order to keep up the necessary gastric ex- 
citement. 

Many other articles of the Materia Medica have been used 
and lauded as digestive tonics, some of which have tonic action 
upon the nervous system, and through this indirectly upon the 
digestive organs, while others, though affecting the alimentary 
canal directly, act merely as disinfectants and absorbents of gasses 
and liquids. It is also a strange fact that ipecac, an active and 
reliable emetic, in minute doses has some celebrity as a digestive 
tonic. 

Subnitrate and Subcarbonate of Bismuth, which seem to act more 
as absorbents of superabundant fluids and gasses, is a popular 
remedy, in connection with ipecac and mercury, for the treatment 
of indigestion. In cholera infinitum, and other forms of acute 
diarrhoea, without regard to its origin in interitis, or exhalation 
of fluids into the canal, bismuth is highly prized as a remedy. 
One practitioner concludes it is a powerful sedative, while an- 
other values it only as an absorbent. 



AND THERAPEUTICS. 25i 

DIVISION II. 

REMEDIES THAT AFFECT THE HEART. 

To all the classes of this division, names have heretofore been 
given denoting an action upon the arteries instead of the heart 
itself. This popular nomenclature had its origin in the opinion 
that the movement of the arteries constitutes the propelling force 
exerted upon the blood in carrying on the circulation, and that, 
consequently, remedies affecting the circulation do so through 
their action upon these vessels. It is with some misgivings, as 
to propriety, that we vary from this long-established course. 
Nothing but the practical advantage of making the name of 
each class describe the direct physiological action had by it, could 
have induced this innovation. The author is aware that con- 
fusion arises, and great embarrassment is imposed upon the 
learner by a multiplicity of terms for the same thing; but, on 
the other hand, practical error is the result of continuing those 
not in accordance with the acknowledged action produced. When, 
however, a term is merely nominal, and affects no practical ques- 
tion, as that of artery, which, though originating in the erroneous 
opinion that these vessels carry air, it is not necessary to change, 
because the name is arbitrary, and carries with it, to the student 
of anatomy, no idea now of its office or function. Not so with 
the names of classes in acology. Each is intended to describe 
the manner of action, and the part affected. 

CLASS I. 

CARDIAC STIMULANTS. 

Cardiac stimulants, as the name implies, excite the heart to 
increased action by their direct impression upon the organ. With 
this strict definition, very few articles properly belong to the 
class. A majority of the remedies that modify the circulation, 
do so by their indirect influence, and are not, therefore, recog- 
nized as cardiac stimulants, strictly speaking. The state of the 
nervous influences has a great deal to do with the heart's action 



252 iCOLOGl 

and the condition of the capillaries, favoring normal circulation 
of the blood. When from enervation the heart acts feebly, or 

the small blood vessels arc rendered unfit to perform their func- 
tion, remedies directed to the nervous centres prove indirect 
stimulants to the organs of circulation. This being the most 
frequent source of depressed circulation, neurotics, which restore 

the required nervous influence, are properly used and often termed 
arterial stimulants. 

It is true that there are not only few cardiac stimulants, strictly 
speaking, but very few instances occur in which direct excitants 
of the heart are required. Sometimes at the conclusion of pro- 
tracted inflammatory disease, the heart, as well as other vital 
organs, .is left feeble from its long-continued over-action, and, in 
connection with stimulation to other vital centres, cardiac stim- 
ulants are useful. The nicest discrimination is often necessary 
to determine the true cause of feeble action of this organ, im- 
perfect peripheral circulation does not always depend upon a 
want of strength in the heart's contractions. Active and vigor- 
ous movement of it is frequently found to exist when pulsation 
at the wrist is imperceptible, on account of disturbed capillary 
circulation. Under such circumstances, remedies that excite the 
heart directly cannot be of any service. That which promotes 
innervation and nutrition of the various parts of the body is 
more likely to restore equilibrium of circulation. Ordinary con- 
gestion, in which the central blood vessels are oppressed by the 
accumulation of blood in them, leads to violent contractions of 
the heart, but, notwithstanding this, the impulse is barely per- 
ceptible in the small arteries. In this case, the difficulty cannot 
reasonably be attributed to a want of energy in the central or- 
gan of circulation, nor can relief be looked for in the action of 
cardiac stimulants. Depression of the nervous energies is evi- 
dently the radical difficulty to be met, and to neurotics alone can 
we look for relief of the embarrassed circulation. The shock 
communicated to the nervous centres from violent injuries de- 
presses the nervous influences, brings about a similar state of the 
circulation, and requires temporary nervous excitants, not car- 
diac stimulants, to maintain these functions. 



AND THERAPEUTICS. 253 

Catalogue of Cardiac Stimulants. 

Capsicum, 

Oleum Terebinthina?, 

Ammonii Carbonas. 

Capsicum — Cayenne Pepper. 

This remedy has already been described under the head of 
Rubefacients. 

Local excitement, irritation and pain is produced in any part 
of the body to which it is applied. As a local stimulant, pepper 
differs from other irritants in its action upon superficial inflam- 
mation. While croton oil, mustard and tartarized antimony 
aggravate local irritation, however slight and superficial, this 
article, though producing pungent pain of the part, leaves a 
soothing influence, and counteracts the tendency to inflammation 
already existing. Therefore, an infusion of pepper, gargled or 
swallowed frequently, has a very salutary effect upon the mucous 
membrane of the throat when slightly inflamed. Pepper is one 
of the most prompt and useful cardiac stimulants, exciting the 
circulation without undue impression upon the nervous system, 
or any other part of the body. Its impression is supposed to be 
so powerful upon the heart, that the congestion consequent upon 
the enervation of the capillaries in ordinary chill, is Said to be 
prevented, if anticipated at the proper time, by the administra- 
tion of this remedy. A paroxism of intermittent fever may per- 
haps be prevented in this way. Pepper may be given in sub- 
stance in the dose of fifteen grains. 

An Infusion, made by pouring a pint of hot water on sixty grains 
of contused or pulverized pepper, though non-officinal, is a com- 
mon form of preparation for immediate use. The dose is tico or 
three ftuidounces, repeated in half an hour, if necessary. 

Tinctura Capsiei — Tincture of Capsicum — is an officinal prep- 
aration, in which the remedy may be kept for use, without dan- 
ger of deterioration from time. This is a more concentrated 
form, of which one or two fluidrachms afford the usual effects of 
pepper. 



254 ECOLOGY 

Oleum Ibbebinthin^j — Oil of Turpentine. 

This is the distilled oil of the oleoresinous exudation from 
the various species of Pinua and Abies, described in the class <>* 
rubefacients. 

Spirits of turpentine is a highly inflammable volatile, trans- 
parent thin liquid, of peculiar odor, and somewhat sweetish, 
pungenl taste. As a cardiac stimulant, it has been found useful 
in low forms of disease, particularly typhoid fever, and the pros- 
tration of acute bronchitis and pneumonia. Being an excitant 
of the mucous membranes generally, the stimulation given to 
the alimentary and bronchial surfaces is highly useful in the latter 
stages of these diseases, when increased action of the heart is also 
desirable. It is, of course, inadmissible during the active state of 
inflammation in these membranes, not only on account of the 
direct excitement given to them, but also the injurious effect of 
increased action of the heart under such circumstances. In ty- 
phoid fever, when the tongue is red and clean, indicating exces- 
sive excitement of the alimentary mucous membrane, turpentine 
is generally injurious. On the other hand, when it is dark, 
cracked, or clearing off in patches, with pale edges, the remedy 
may be given with marked benefit. In chronic irritation, and 
other unhealthy conditions of the mucous membrane of the uri- 
nary organs, turpentine is an efficient remedy, from its direct ac- 
tion upon the mucous surface, even when increased activity of 
the circulation ib not called for. Bronchorrhcea, dependent upon 
relaxation and debility of the lining surface, and even in some 
forms of chronic inflammation of the respiratory mucous mem- 
brane, it may be directly applied to the part by inhaling the va- 
por. Evidences of acute excitement, however, afford good rea- 
sons for witholding it. This special action of the remedy upon 
the mucous membranes has no connection with its effect upon 
the heart, but is irregularly introduced at this place to show 
under what circumstances it is contra-indicated, even when the 
heart may require its action. Its blennymenal action is more 
particularly described under the proper head. 

As a cardiac stimulant and excitant of the mucous membranes, 



AND THERAPEUTICS. 255 

it is used in the dose of about twenty drops, rubbed with sugar 
or gum, and suspended in water. 

Ammonii Carbon as — Carbonate of Ammonium. 

This salt is made by subliming a mixture of muriate of am- 
monia and chalk (carb. lime). Thus made, carbonate of am- 
monium is in the form of hard, translucent, crystaline masses, 
very volatile, of pungent taste, and penetrating odor. When 
exposed to the air it effloresces, falling into an inodorous, inert ? 
tasteless, opake white powder. In order, therefore, to preserve 
its active properties, it should be kept in well-stopped glass 
bottles. 

The several preparations of ammonium diifer so essentially 
from each other in their medicinal and chemical properties, that 
care is necessary in order to avoid the use of incompatible sub- 
stances at the same time. Any free acid or salt, whose acid has 
more affinity for ammonia than the base with which it is com- 
bined, decomposes carbonate of ammonium. Hence, all alkaline 
carbonates, amongstthem carbonate of ammonium, may ordinarily 
be used as uncombined bases, when the alkaline or antacid effect is 
desirable. This circumstance, it seems, would make it necessary 
to give large doses repeatedly, in order to insure the stimulant 
action of carbonate of ammonia upon the heart. 

This is one of the few articles supposed to afford direct cardiac 
stimulation — giving increased vigor, without irritability. The 
pulsations under its influence are fuller and stronger without un- 
natural frequency. 

In the latter stages of bowel affections and protracted fevers, 
particularly when complicated with irritable or inflamed bowels, 
it proves a valuable stimulant to the circulation. Under such 
circumstances, the benefit derived from neutralizing any collec- 
tion of irritating acid, is not less important than its action upon 
the heart. 

The dose is about five grains, made into pills, or dissolved in 
water and taken at once. The unpleasant ammoniacal taste 
makes the solution objectionable, yet in this form its effects can 
be more promptly realized. 



256 &00L0G1 

From what has been -aid of the peculiarities possessed !>v each 
article of this class, it will In- perceived that oil of turpentine is 
preferable as a cardiac excitant, in diseases connected with the 
mucous surfaces, on account of it< blennymenal stimulation. 

Capsicum, by its peculiar local invigoration to the month, throat, 
etc., is rendered useful in passive condition of these parts, with 
general vascular inactivity. And the antacid properties of car- 
bonate of ammonia give it the preference in conditions above 
named. A knowledge of these various properties enables the 
practitioner to make a judicious selection when cardiac stimu- 
lants are required. 

As already intimated, this class is seldom called for. In most 
cases of depressed circulation, the prime difficulty exists in the 
nervous system, requiring neurotics to restore healthy arterial 
action. 

CLASS II. 

CARDIAC SEDATIVES. 

Contrary to what might seem the most rational theory of re- 
storing healthy vigor, this class of depressing agents are more 
potent and generally applicable in the treatment of disease than 
the antagonistic class of stimulants just described. 

The tendency to functional disturbance of healthy organs in 
morbid conditions of the system, and the aggravation of those 
conditions by such disturbance, are facts to be remembered in 
the treatment of inflammations. Local disease excites the heart 
to increased activity, which in turn drives an excessive amount 
of blood into the part, and increases the existing difficulty. To 
prevent this, and facilitate the cure, even when the heart's action 
is' not unnatural, cardiac sedatives are highly useful. 

Cardiac tonics have been recognized in the class now under 
consideration, because by them the heart's pulsations are reduced 
in frequency. The irritable, frequent pulse, however, from de- 
bility, must be distinguished from the excitement of inflamma- 
tion, in order to the proper use of the remedies. 

As before intimated, cardiac sedatives are useful in the treat- 



AND THERAPEUTICS. 257 

ment of inflammatory diseases; and we may add, particularly so 
for such disturbance in the respiratory organs. Pneumonia is 
often treated exclusively by remedies of this kind, and although 
it is not always aborted, nor even shortened in its ordinary cours e 
by them, vet the patient is conducted safely through a regular 
term of eight or en days, and secured against the destructive 
inflammatory action and fatal termination which otherwise might 
occur. 

Catalogue of Cardiac Sedatives. 

Veratrum Viride, Antimonii et Potassii Tartras. 

Depletio, Potassii Nitras, 

Frigidus. 

Veratrum Viride — American Helebore. 

The root of Veratrum Viride, an annual plant with perennial 
root. It grows to the height of three or four, feet, and is found 
in low, moist situations throughout the Northern and Middle 
States. The root is dug in autumn, and dried for use. It is 
dark on the surface, and of ashy-white color internally. The taste 
is acrid and bitter, leaving an unpleasant sensation in the fauces 
for some time after being swallowed. In the crude state it soon 
deteriorates, and should therefore be preserved in some suitable 
form of preparation. 

Veratrum has attained to more celebrity as a cardiac sedative 
in the treatment of inflammatory diseases, particularly pneumo- 
nia, than any article of the class. Whilst some are more perm- 
anent in their effects, other peculiarities render them less safe in 
violent disease. Although nausea and great prostration of the 
vital energies sometimes follow full doses of the remedy, yet no 
local irritation is produced, and the timely administration of a 
little brandy and opium arrests these symptoms promptly. 

It is a singular fact that, under its influence, inflammatory 
symptoms seem to subside almost entirely, but return to the full 
extent if the sedative effect be suffered entirely to subside. The 
regular administration is necessary, therefore, to prevent injurious 
results from the local inflammation, and must be continued the 
17 



258 



ECOLOGY 



usual duration of 'any particular disease under treatment, or until 



Fig. 24. 




Veratrum viride. 



the heart's pulsations 

Cease tO increase be- 
yond their ord inary 
frequency. 

In pneumonia, for 
example, an ordinary 
quantity should be re- 
peated every two to 
four hours, until the 
pulse is reduced to, or 
below, the normal 
standard ; then at long 
intervals and in proper 
amount to keep the 
circulation at this 
point. This course 
will secure comfort to 
the patient, and pro- 
tect the lung from dan- 
gerous results, likely 
to follow the inflam- 
matory process. 

In combination with 
some preparation of 
opium, it is a useful 
sedative in catarrhal 
fever, bronchitis, and 
other local develop- 
ment of irritation aris- 
ing from influenza. 
While the opiate does 
not materially inter- 
fere with the produc- 
tion of cardiac seda- 
tion, it prevents the 
unpleasant nausea of 



AND THERAPEUTICS. 259 

veratrum, and allays for a time the irritation upon which de- 
pends the distressing cough so annoying under such circumstances. 

Tindura Veratri Viridis — Tincture oj Veratrum Viride. This 
is the most important preparation of veratrum, and that in which 
the remedy is generally used. It consists of a saturated solution 
of the active principle in alcohol, is a convenient form for ad- 
ministration, and may be kept for any length of time without 
risk of deterioration. 

The administration may be commenced in the dose of about 
four drop* every two hours, and increased or diminished as may 
be found necessary. Some subjects are more readily affected than 
others, and it is only after testing the effect in any particular case 
that the exact amount, and length of interval to be observed 
between the doses, can be positively determined. 

Extractum Veratri Viridis Fluidum — Fluid Extract Veratrum 
Viride. This is perhaps a more concentrated preparation than 
the tincture, but being somewhat uncertain as to the strength, it 
has no advantages, and is not, therefore, preferable on any ac- 
count. In commencing its use in a particular case, the dose 
should not exceed two or three drops, but may be increased, if 
necessary, as directed for the tincture. 

Depletio — Blood-Lett ing. 

In order to appreciate properly the sedative effects of blood- 
letting, its physiological influence upon the heart and other or- 
gans must be understood. The two cavities in each side of the 
heart are filled alternately with blood. During the diastole, it 
is received from the auricle into the ventricle, whence it is 
thrown into the arteries by the systole, or contraction of the 
ventricles. The blood itself is doubtless the natural stimulus 
for the heart, by which, in part at least, these movements are 
regularly performed. 

The increased frequency and force of the pulsations, when 
blood accumulates in the heart from deficient peripheral circula- 
tion, may be thus accounted for. This state of the circulation 
is called general congestion, in which the blood, failing to pass 
from the large arteries through the capillaries, retards the circu- 



2G0 AOOLOGY 

latum, and leaves a larger amount in the heart's cavities, exciting 

more violent contractions. 

Whilst the loss of this direct stimulant of the heart is suffi- 
cient to account for the sedative influence of blood-letting, it is 
known that, by lessening the quantity sent to the brain, by this 
depleting measure the heart's action is also indirectly modified, 

Temporary cessation of its pulsation — ayncopi — may be in- 
duced by suddenly depriving the brain of the necessary amount 
of blood. In proof of this, it may he stated that when fainting 
occurs from sudden abstraction of blood, while in the erect pos- 
ture, resuscitation is readily produced by changing the position 
so as to favor gravitation toward the brain. When, therefore, 
blood is drawn from a subject in the horizontal position, to the 
extent of producing faintness, recovery from it is slow, and, to 
one already enfeebled by disease, may prove hazardous. 

So far as the practical result is concerned, it matters little 
whether the impression of blood-letting be made directly upon 
the heart or through the brain, so that the violent contractions 
are subdued and the quantity of circulating fluid lessened. By 
the latter, however, independently of the former, inflammatory 
action may be arrested in plethoric subjects, and hence blood- 
letting under such circumstances may do what other cardiac 
sedatives fail to accomplish. 

General blood-letting consists in the abstraction of blood from 
a vein or artery so as to lessen decidedly the amount of circu- 
lating fluid. 

Venesection or phlebotomy, the opening of a vein longitudinally 
with a lancet, is the mode usually adopted when full bleeding is 
recp-iired. The median cephalic vein is generally selected for 
this purpose, and should be freely opened in order to allow full 
discharge, and also to prevent swelling and soreness from extrav- 
isation in the cellular tissue. 

A strip of tape or cloth being passed around the arm above 
the elbow, and tied so as to intercept the passage of blood toward 
the heart, the vein becomes prominent, and may be readily 
opened, with a spring or thumb lancet. 

Arteriotomy is the abstraction of blood from an artery, by 



AND THERAPEUTICS. 261 

partially or entirely severing it. The temporal artery is gener- 
ally preferred, being superficially located and lying in close con- 
tact with the unyielding cranium. With the heel of an ordinary 
thumb lancet the artery may be very readily cut. When only 
partially divided, the hemorrhage continues unnecessarily, with- 
out constant pressure upon the cardiac portion of the artery for 
some time. If, however, the artery be completely severed, so as 
to allow its contraction within the cellular tissue, the discharge 
often ceases, even before a sufficient amount of blood escapes. 

The principles already laid down must be observed, in order 
to accomplish the object intended by venesection and arteriotomy. 
Reaction from syncope is often so violent that the heart's pulsa- 
tions are even more active than before the bleeding. This, of 
course, interferes with the main object of blood-letting. In order 
to avoid syncope, and at the same time prevent difficulty attend- 
ant upon free bleeding in the lying posture, the patient should 
occupy a semi-recumbent or sitting position. When the pulse 
is sufficiently reduced, or when yawning, thirst or giddiness in- 
dicates approaching syncope, the horizontal position should at 
once be assumed. 

The effect upon the heart, and not the absolute quantity of 
blood drawn, should determine the time to arrest the flow. 
About sixteen fluidounces is generally required to make sufficient 
impression, and to cause the necessary depletion for other pur- 
poses. 

The quantity of blood discharged at a given time, and the po- 
sition of the patient, have much to do with the sedative effect of 
blood-letting; hence, when it is desirable to produce syncope for 
its powerfully relaxing influence in strangulated hernia, disloca- 
tion or rigid os uteri, the erect position is selected, and a large 
orifice made, or a vein in each arm opened at the same time. On 
the other hand, when depletion to the greatest extent, without 
sudden prostration, is desirable, the sitting posture should be 
taken, and the blood abstracted slowly. 

Several of the phlegmasia? require this depletory antiphogis- 
tic treatment. Cerebro-spinai meningitis, pleuritis, peritonitis, 
pneumonia and orchitis are among the most prominent. 



2()2 ACOLO< 

In pneumonia, when the inflammation is extensive and vio- 
lent, so as to prostrate the vital energies from shock, or when 
greatly depressing influences surround the case, bleeding, (<> any 
extent, cannot be safely practiced. By watching closely the 
efleel during the flow, however, it may be tested during the early 
Stage of any case, as some benefit may be derived from the loss 
of a few ounces only. 

The ruling character of disease prevailing at any particular 
time, or special locality, may require a modification in the treat- 
ment of all affections, particularly in regard to depletion of any 
kind. 

When adynamic fever prevails as an epidemic, all diseases oc- 
curring within the bounds of its influence partake, more or less, 
of the general tendency to prostration, and will not allow active 
depletory measures. This was particularly observable while ty- 
phoid fever prevailed in Georgia during the decade commencing 
in 1850. So decided was the tendency to depression in ordinary 
inflammatory diseases during this period, that blood-letting and 
drastic cathartics were almost entirely abandoned. Perhaps 
these means of treatment were too generally proscribed, for the 
abstraction of blood and other depletory measures, even under 
these circumstances, were doubtless sometimes necessary. Now, 
since this influence no longer exists, they are certainly useful, 
and yet the professsion is slow in returning to this rational mode 
of treatment. The adynamic tendency caused by throwing to- 
gether large numbers, under the hospital arrangement heretofore 
adopted, is similar to that just referred to, and therefore the 
active treatment by which inflammatory diseases are promptly 
cured, when isolated and in airy situations, cannot be safely 
adopted in the crowded hospitals of Europe. 

Bennett's expectant and supporting plan for the treatment of 
pneumonia may do very well under the depressing influences con- 
nected with the situations in which his statistics were made, but 
will avail nothing in the private practice of this country. Ap- 
parent debility does not always amount to exhaustion, and de- 
pletion may sometimes afford the best means of relief. 

Cerebro-spinal meningitis often exhibits symptoms of the most 



AND THERAPEUTICS. 263 

complete prostration at the very outset, and would seem to for- 
bid the lancet, yet recent experiments, induced by alarming mor- 
tality attending the tonic treatment, prove that an antiphlogistic 
course of treatment is eminently useful. 

A statistical report of cases, made by the author to the Georgia 
Medical Association in 1873, establishes this fact, and that blood- 
letting may be resorted to when very great prostration exists. 
Even when the circulation is so feeble that the blood will scarcely 
flow without being stripped from the arm, reaction seems to have 
been promoted by the discharge. Faintness is not likely to occur 
in meningeal inflammation, however great the depression may be, 
because the brain is then greatly engorged, and it would be dif- 
ficult to deprive it of blood in sufficient amount to produce syn- 
cope by opening a vein in an extremity. Indeed, the prostra- 
tion depends, in a good degree, upon mechanical pressure on the 
centre of nervous power by the congestion; and, instead of faint- 
ness, greater vigor will follow the abstraction of a portion of this 
source of oppression. 

Peritonitis, whether puerperal or otherwise, is very much under 
the control of blood-letting, as well as other depleting and coun- 
ter-irritant means. Full, bounding pulse, the usual criterion for 
bleeding, does not exist, and should' not govern the practitioner 
in this disease. Though frequent and small, there is not that 
want of unyielding firmness found in the rapid pulsations of 
exhaustion and nervous irritability. 

Pleurisy and orchitis usually exhibit that state of the circula- 
tion which all admit should authorize copious bleeding. But 
for the practice having gone measurably into disuse, few would 
hesitate to relieve the pain, and other symptoms of high inflam- 
matory excitement, by venesection. 

Members of the medical profession are too prone to adopt 
systems of practice which ignore the labor of discriminating 
thought, the exercise of judgment in diagnosis, and the physical 
exertion incident to the application of successful treatment. One- 
ideal systems have their origin in this indolent tendency of the 
profession. No mental or physical effort is required to use sugar 
granules, steam or water indiscrimately in all cases. It is also 



v Jiil ACOlOGl 

easy and ii«» less injurious to adopt the supporting or depleting 
treatment, regardless of circumstances or conditions. The indus- 
trious exercise of reason, judgment and physical power are essen- 
tial to the success of practical medicine always. 

Local blood-letting is the abstraction of blood from the skin or 
other surfaces, by cups, leeches and scarification, and is intended 
to deplete contiguous parts in a state of engorgement or inflam- 
mation. In anaemic or very young subjects, this will effect suffi- 
cient general depletion to produce cardiac sedation, and hence, 
may, with propriety, be considered in this connection. 

] [initio — The Leech — described under the head of "mechan- 
ical counter-irritants and local depletives," are preferable to other 
modes of depletion in some cases of local congestion or inflam- 
mation. Certain localities do not admit of cupping and acu- 
punctration, while leeches may be applied to- any part of the 
body subject to ocular inspection. A fluidounce of blood may be 
obtained from each leech, by encouraging the flow after it falls 
off, and when placed directly upon the diseased part, two or three 
will draw a sufficient amount for ordinary purposes. The ex- 
tent and intensity of the derangement, and the direct or remote 
application made of them, however, are circumstances which 
vary the quantity required in a given case. If applied directly 
to the uterus, for example, more benefit will be derived from two 
leeches than from half a dozen placed over the hypogastrium. 
When drawn from the temples, in congestion or excitement of 
the brain, nothing short of an amount of blood sufficient to de- 
plete the general circulatory system decidedly will give percepti- 
ble relief. This may be effected, in children or aduts easily im- 
pressed by bleeding, with six or eight leeches. 

Cupping, as a depletory measure, consists in scarification and 
the application of cups made of glass, tin or horn to the skin, 
by partially exhausting them of air. The process is described 
under the head of "mechanical counter-irritants and depletives," 
to which the reader is referred for further information. 

A sufficient amount of blood may be abstracted from the 
temples to affect the general circulation in cephalic and menin- 
geal disease, and at the same time act as a temporary counter- 



AND THERAPEUTICS. 265 

irritant. This last effect makes cups preferable to leeches when 
applied externally and only contiguous to the diseased part. 

A fluidounce of blood, and sometimes more, may be taken 
from one scarification. This depends upon the vascularity of 
the part, and the depth of incisions made with the scarificator. 
In a case of cerebro-spinal meningitis, to which the author was 
called in consultation, with Dr. E. L. Connally, not less than 
fifteen fluidounces of blood were drawn by cups to the temples, 
back of the head and neck, the patient in his semi-delirium ob- 
jecting to venesection and arteriotomy. 

Scarification, independent of cups, is an efficient means of re- 
lieving engorgement and inflammation of the tonsils, and by 
some considered preferable to leeches, for similar conditions of 
the uterus. Incisions made with a bistoury or gum-lancet at 
several points on the gland, lead to considerable hemorrhage and 
to the arrest, sometimes very promptly, of acute tonsilitis. 

A spear-pointed, delicate instrument is in use for scarifying 
the uterus, by which the os and neck are pierced in several places 
for the relief of local congestion. 

Fmgidus — Cold. 

The temperature of the whole body, or a part only, may be 
reduced, so as to cause general or local sedation. Various appli- 
cations may be made for this purpose. 

Cold Water poured on the body, changing from one part to 
another in quick succession, or sponging the surface in febrile 
excitement, lessens the heat, and has a decided control over the 
circulation. 

The application of cold in any manner to the head, particu- 
larly the affusion of water, proves decidedly sedative to the 
•heart. In this case, however, the effect is probably indirectly 
brought about by reduction of the temperature and consequent 
depressing effect upon the brain, and therefore may be found 
more decidedly useful in radical lesions of this organ itself. 

The paroxysms of heat and delirium that sometimes attend 
meningitis, after the usual depletory measures have been adopted, 
are greatly relieved by pouring cold water upon the head for 



266 a< lotOGl 

half an hour, with two or three intermissions of five minutes. 

The patient often becomes calm and inclined to Bleep during the 
affusion. 

Ic<\ swallowed in small pieces, not only allays irritation and 
inflammation of the stomach itself, but by the refrigerating in- 
fluence upon this great central organ of the body, a more or less 
general sedation is secured, through the vascular and nervous 
connections with other parts. Crushed ice, in oil-cloth or 
rubber bags, may be advantageously applied to the head when 
it is desirable to reduce excitement and heat in meningitis, en- 
cephalitis, etc. 

For local refrigeration, the application of very volatile liquids, 
such as ether, chloroform and alcohol, to the uncovered surface, 
may be used with advantage. Caloric is abstracted, and the 
temperature reduced by them in proportion to the rapidity of 
evaporation. This is facilitated greatly by the 'atomizer, an in- 
strument used to apply liquids in the form of spray. 

Rigoline, the most volatile of known liquids, is used in this 
way for the most speedy and perfect refrigeration. Not only is 
ordinary sedation, by reduction of temperature, produced, but- 
local anaesthesia readily induced, so that surgical operations for 
affections connected with superficial structures may be performed 
without suffering to the patient. 

As a means of controlling inflammation situated internally, 
and of preventing its occurrence in external injuries, refrigera- 
tion in the various modes above alluded to is justly entitled to 
confidence. Wounds of every description are treated with cold 
water dressings, in order to prevent the development of inflam- 
matory action likely to ensue. This plan of treatment, however, 
should not be adopted to the exclusion of emolients when required. 

Antimonii et Potassii Tartras — Tartrate of Antimony and 

Potassium. 

This salt has already been described under the head of emet- 
ics. In that class it stands as a prominent article, and is now 
mentioned only in connection with its direct influence upon 
the heart. 



AND THERAPEUTICS. 267 

It has already been stated in the remarks upon emetics, that 
nausea, from any cause, depresses the vital energies generally. 
Cardiac sedation is thus brought on by all nauseants, as one of 
the indirect temporary results. The action to which we now call 
attention is not dependent upon, nor does it have any particular 
connection with nausea. Tartar emetic produces each of these 
effects bv a separate elective action upon the heart and stomach. 
Sedation is more perfect — at any rate, more permanent — when 
no nausea exists. Hence, when tolerance of its effects upon 
the stomach can be obtained, the greatest amount of cardiac 
sedation is secured. If the stomach, by repeated doses, can be 
made to lose its susceptibility, and tolerate one grain, the heart's 
action may be controlled to any extent desirable. 

In the dose of one-eighth to the fourth of a grain, repeated every 
hour or two, tartarized antimony has a controlling influence over 
the heart's action, so as to lessen its force and frequency percep- 
tibly. The property, however, of irritating the gastric mucous 
membrane before mentioned, renders this valuable sedative inad- 
missible in many cases which would otherwise be greatly bene- 
fited by it, and on this account caution in its use is necessary. 
When it can be used in pneumonia and other inflammatory affec- 
tions, without decided irritation of the stomach and bowels, it 
proves one of the most efficient sedatives at the practitioner's 
command. Its effects are more permanent than those of vera- 
trum and blood-letting; so much so that when symptoms are 
once controlled, they do not readily return. 

In order, as far as possible, to protect the alimentary mucous 
membrane against irritation, the salt should be given in some 
demulcent fluid, such as acacia, flax-seed, or elm mucilage. 

Potassii Nitras — Nitrate of Potassium. 

Nitre, or Saltpetre, as this salt is sometimes called, is in small 
crystaline masses, soluble in water, and not unpleasant to the 
taste, leaving in the mouth a sense of coolness. The natural ten- 
dency to irritate the alimentary mucous membrane renders its use, 
like that of tartar emetic, objectionable in cases liable to injurious 
disturbance of this part. 



268 ACOLOGV 

Nitre is doI generally used as a Bedative in the treatment of 
inflammatory diseases, but doubtless might be given with advan- 
tage in peritonitis, pnemonia, etc. In the treatment of perito- 
neal inflammation, the irritation it produces in the mucous sur- 
face, so far from making it objectionable, would seem to favor 
its use, as a kind of counter-irritation is thus afforded. In this 
way it is supposed that drastic cathartics act favorably in peri- 
tonitis. 

In acute nephritic inflammation, nitre is also peculiarly appli- 
cable, on account of its renal sedative property, but the most fre- 
quent -use made of it as a sedative is in the treatment of certain 
forms of chronic cardiac derangement, leading to hydrothorax, 
and other dropsical collections. While its sedative influence 
upon the heart tends to lessen effusion, the depleting effect of 
increased diuresis, which often follows its use, makes the absorp- 
tion of dropsical fluids more active. 

As a gentle refrigerant, renal and cardiac sedative in febrile 
conditions, requiring at the same time increased excitement of 
the liver, a combination of nitre, tartarized antimony and calo- 
mel, called nitrous powder, has been used with advantage. The 
amount of nausea produced by the eighth of a grain of antimony, 
as found in a dose of this preparation, also aids in the produc- 
tion of cardiac sedation. 

Nitre is given in the dose of ten to fifteen grains, dissolved in 
water or flaxseed tea. 

Acid Drinks are more or less sedative to the circulation, and 
always prove refrigerant and grateful to the stomach in febrile 
disturbance. 

The Effervescing Draught, composed of a solution of ten grains 
citric acid in one glass, and a like quantity of bicarbonate of 
soda in another, poured together and drank while effervescing, is 
decidedly refreshing, and calms arterial excitement. Xausea and 
a sense of heat in the stomach are often allayed by this draught. 

Lemonade, particularly when cooled with ice, and sweetened 
to taste, is also an agreeable and useful beverage for these pur- 
poses. This is also useful in allaying the tormenting nausea fol- 
lowing the use of opium. 



AND TIIERArEUTICS. 269 

CLASS III. 

CARDIAC TONICS. 

That peculiar condition of the heart in which the pulsations 
are frequent and sometimes forcible, depending upon organic 
lesion and irritability, is favorably affected by certain remedies 
known as arterial sedatives, but now recognized by some of the 
best therapeutists as tonics. Practically, this action has been 
admitted, so as to limit the application of these articles to the 
treatment of chronic organic functional disturbance of the heart, 
in which a want of tone is evident. Experiment has proved 
their value in these conditions, and the author's opinion of their 
modus operandi places them in the class of cardiac tonics. 

It is not certain that cardiac tonics or sedatives influence the 
circulation entirely by direct action upon the heart. Some arti- 
cles of each class are known to affect the brain, and it has not 
been ascertained how much of the control over the circulation 
may be thus indirectly brought about. Indeed, the direct action 
of many remedies, whose effects are first prominently manifested 
in certain organs, and hence considered direct, may hereafter be 
proven to result from elective influence upon the nervous centres. 

Classifications are made, however, with reference to the opinion 
now entertained of their direct elective action, founded upon ex- 
perience in* their use. Other facts, leading to different conclu- 
sions, may hereafter be made known, when changes in accordance 
therewith must be had. Perfection in a progressive science must 
not be expected. But for the advancement made in physiology 
and therapeutics within the last twenty years, innovations upon 
the arrangement of former works on these subjects would not 
now be called for. A like period in future will, in all probabil- 
ity, make other changes equally necessary. 

Catalogue of Cardiac Tonics. 

Digitalis, 

Prunus Virginiana, 

Acidum Hydrocyanicum. 



270 ACOLOGY 

I ) ! ( ; ita i i 1 8 — FoxgloVi . 

The [eaves of Digitalis Purpurea, an herbaceous plant, with 
biennial root, native of Europe and cultivated in the United 

State-. The leaves should be gathered in the second vear and 
during the flowering period. Care is necessary in collecting and 

drying them, and to a neglect of this perhaps the occasional 
failure of its action upon the system is due. It is recommended 
that they be dried by a geutle heat, stirring so as to prevent 
their adhering to each other. Digitalis is supposed to deterio- 
rate by time, though properly dried. The remedy is preferable, 
therefore, when kept in the form of such preparations as are 
likely to preserve the active virtues more perfectly. 

No article in the Materia Medica has been so imperfectly un- 
derstood as the one under consideration. Evidence of this is 
found in the very contradictory statements of its physiological 
action and therapeutic results. It was once universally consid- 
ered a sedative to the circulation, and yet in the treatment of 
inflammatory diseases has not been found useful. The remedy 
has been considered effectual in controlling the circulation only 
when the central organ is irritable from debility after exhausting 
chronic disease, in which the pulsations are frequent and some- 
times feeble, requiring excitants or tonics to restore normal action. 
Hence, digitalis has proved satisfactory in its impression upon 
the circulation in the exhaustion of inflammatory disease, phthisis, 
etc., in which hectic irritability exists, and in organic cardiac 
disturbance. 

With respect to the action of digitalis, grave errors have been 
entertained, not only as to the class in which it properly belongs, 
but in regard to the degree of action and cumulative tendency it 
possesses. Fifteen years ago it was supposed to be poisonous, 
not only in large or overdoses, but in moderate quantity given 
for some time. Violent symptoms were expected to appear sud- 
denly from the pent-up or cumulative effect in the system. This 
was the settled opinion of its properties for half a century, and 
until experiment proved it not only safe but efficient in the dose 
of half a fluidounce for the treatment of delirium tremens, it 
was given with caution in the ordinary amount. 



AND THERAPEUTICS. 



271 



It is one of the articles usually classed with arterial sedatives, 
but is considered useful only in derangement of the circulation 

dependent upon chronic car- 

v a? *• u Fie- 25. 

diac affections, such as we 

think are benefited, as above 

intimated, by tonic instead 

of sedative action. 

The pulverized leaves may 
be given in substance, but 
are sometimes inactive from 
deterioration. In the form 
of pills this powder is often 
associated with other agents 
having similar or other pro- 
perties necessary in the par- 
ticular case. More durable 
preparations are, however, 
preferable. 

In substance, digitalis may 
be given in the dose of one 
to three grains. The opinion, 
heretofore entertained, of its 
dangerously cumulative tendency, led to the restriction of the 
dose to one grain, but since it has been ascertained that five 
times this amount may be taken with impunity, it is not unrea- 
sonable to suppose that more decidedly beneficial results may be 
obtained from its use as a cardiac tonic. 

Tinctura Digitalis- -Tincture of Digitalis — is perhaps the best 
form of preparation, for convenient administration, and for per- 
fect preservation from deterioration by time. About ten drops 
of the tincture correspond with one grain. It may be given, 
therefore, in the dose of ten to twenty drops. 

An Extract and Infusion are officinal, but in the forms of 
powder and tincture, all that is necessary for convenience of 
administration and for the full effects of digitalis may be ob- 
tained. 




Digitalis purpurea. 



979 



ACQ LOGY 



Pbuhus Vlegeniana — Wild Cherry, 
The hark of Cerasus 8erotma f or WUd Cherry, a forest tree, 

Dative of the Tinted Slates, and found abundantly in most parts 
oi' the country, North and South. The invigorating effects of 
wild cherry has been so marked in prostration from chronic dis- 
eases that the article was supposed to ad as a tonic upon the di- 
gestive organs. Containing a bitter principle, it is easy to imag- 
ine that it possesses the properties of digestive bitter tonics, and 
therefore stands as a prominent article in that class with most 
authors. Unfortunately for its position amongst them, however, 
such observers as Pereiraand Wood have ascertained that, in full 
doses, so far from promoting digestion, this function is actually 
embarassed by it; and, though receiving from them a quasi re- 
cognition as a bitter tonic, is recommended only in such cases as 
we have described for the action of cardiac tonics. Like digi- 
talis, it lessens the number of pulsations only when, from irrita- 
bility, the frequency becomes excessive. In the hectic of con- 
sumption, and other forms of debility, from extensive suppora- 
tion, etc., its good effects are exhibited. 

Wild cherry contains prussic acid, or volatile principles con- 
vertible into this acid during the process of preparation. Upon 
this its tonic property in all probability depends, and in order to 
insure the full effects of the drug, such preparations only should 
be used as have not been subjected to a degree of temperature 
much above 100° degrees, Fahrenheit. 

Infusum Pruni Virginiance — Infusion of Wild Cherry. This 
may be prepared extemporaneously by the immersion of half a 
troyounce of the bruised fresh or dried bark in a pint of water. 
By percolation on the displacement plan, the preparation may be 
made from the powdered bark, avoiding always the use of very 
warm water. The dose is two or three fluidowices three times a 
day. 

Syrupus Pruni Virginiance — Syrup of Wild Cherry — is offi- 
cinal, and affords an agreeable preparation. The dose is half a 
fluidounce three times a day. 



AND THERAPEUTICS. 273 

Acidum H ydrocyanicum Dilutum— Diluted HydrocyanieAeid. 

This is a transparent volatile liquid of peculiar odor and taste 
and should be kept in well stopped bottles protected from the light. 
The direct action of this very powerful remedy and virulent 
poison is not satisfactorily determined. By some writers it is 
supposed to exert its influence upon the heart, and, as evidence, 
they mention the short time required to develop symptoms of its 
effects. On the other hand, physiological investigations have 
established the fact, as stated on page 44, that the rapidity with 
which volatile substances may be carried to the brain through 
the circulation renders altogether possible the theory of its neu- 
rotic action. Indeed, some of the symptoms of its poisonous 
action seem to be the result of nervous disturbance. In connec- 
tion with the action of this acid, it has been said that proof is 
afforded to sustain the theory that impressions are made upon the 
nervous centres and this system generally, by the action locally 
on a nervous filament to which it is applied. This opinion, 
however, is not sustained by experiments. 

That neurotics generally affect the system only through the 
impression made upon the centres, is a fact well established by 
physiological investigations. It is at the same time believed that 
certain powerful neurotics do, to some extent, affect the. nerves 
themselves when applied to them. Such impressions, however, 
are not conveyed to and do not affect the brain, as was once 
supposed. 

In what is known of its action, there is certainly evidence of 
special impression upon the heart, as well as the nervous centres, 
by prussic acid. Some of the seemingly contradictory opinions 
in regard to the particular organ upon which this substance acts 
directly, may be readily reconciled by considering it capable, like 
many others, of acting directly upon more than one organ at the 
same time. It is evidently a cerebral sedative, and in poisonous 
quantity destroys the functions of this vital organ. It is also 
known to modify the heart's function, but not as a sedative, for 
experiments prove that the heart's action is the last of three im- 
portant functions lost under its influence. From this and other 
18 



274 ACOLOGY 

fuels connected with its action upon the heart, the reasonable 
conclusion must be that normal vigor is given that organ, under 
the circumstances above described, in which cardiac tonics prove 
useful. 

The dose is two to six drops, commencing always with the min- 
imum quantity, so as to avoid unnecessary action. A gradual 
increase may be made until the maximum quantity is arrived at 
or until the desired effect shall have been produced. Half a 
fluidrachm of the diluted acid, in two fluidounces of water, 
makes a proper strength to be taken in the dose of a teaspoon/id, 
gradually increased to two or three, or until the desired impres- 
sion is made. In this way the unpleasant effects of overdoses 
may be avoided. 

Potassii Cyarridum — Cyanide of Potassium. This salt of po- 
tassium possesses properties similar to those of hydrocyanic acid, 
and also requires care in its use to prevent unpleasant poisonous 
effects. It may be given in the dose of an eighth of a grain, 
three times a day, dissolved in water. 



DIVISION III. 

REMEDIES THAT AFFECT THE MUCOUS MEMBRANES. 

This new division is introduced with some misgivings as to 
the propriety of making such decided innovation on long-estab- 
lished arrangement of classes. The necessity for it is more par- 
ticularly deplored on aecount of the fact that the division is 
made to supersede one that has long been considered important 
in the classification of remedies. In order to carry out the 
plan of this work, however, it is absolutely necessary to do so. 

Divisions of medicinal agents must be made with reference to 
the organ, system of organs, structures or fluids upon which the 
direct physiological action of remedies thus associated is exerted # 
It will be seen that the most prominent articles of this division 
have usually been designated as agents affecting the respiratory 



AND THERAPEUTICS. 275 

and urinary organs, and classed as "expectorants" and "diuret- 
ics," in accordance with the* uncertain functional changes some- 
times resulting from their action. 

As an apology for this radical change, it may be stated that 
the recognition of well-established, practical facts is sought, in 
preference to theories of very questionable soundness. It is an 
undeniable fact that a number of articles in the division of 
"remedies affecting the respiratory organs," and classed "expec- 
torants," have an elective stimulant action upon the mucous 
membranes generally. By such, the function of expectoration 
is modified only through this direct, exciting effect upon the 
mucous tissue. The same may be said of certain "emmena- 
gogues" and "diuretics," whose therapeutic effects, as such, are 
dependent upon the excitement produced in the mucous mem- 
branes of the uterus and kidneys. The fact that such stimulants 
add to the difficulty, when dependent upon over-excitement of 
the organs, may be stated as a practical objection to this careless 
mode of classifying remedies. 

Expectorants, so-called, consisting of remedies whose elective 
action is that of excitement of the respiratory mucous membrane, 
increase the difficulty when deficient expectoration depends upon 
an excited or inflamed condition of the organs of respiration or 
their lining surface. N#w, since inflammatory excitement is 
generally the cause of deficient expectoration, excitants of the 
mucous membranes called "expectorants," prescribed as such, 
without reference to their direct action, may cause injurious re- 
sults. But when the name of a class indicates the kind of action 
and the part acted on, there will be no difficulty in prescribing 
them properly when the true pathological condition is understood. 

As another reason for discarding the division of "remedies 
that affect the respiratory organs," we mention the fact that 
"expectorants," the only legitimate class belonging to the divi- 
sion, is a term implying an action which really has no existence 
except as the result of different and sometimes opposite actions. 



276 ACOLOGY 

CLASS I. 

BLENNYMENAL STIMULANTS. 

This class, as the name implies, is made up of articles which 
excite the mucous membranes. The tissue is affected, not in one 
organ exclusively, but in all, wherever found, by a direct elective 
influence, recognized as a physiological, action of the remedies. 

Blennymenal — from ■iliyyu., mucus, and u/jqv, a membrane — 
indicates the part upon which the remedies now under consider- 
ation act. While all articles of the class tend to excitement of 
this structure, their effects difFer essentially in degree. Some 
make very slight impression; others cause a high state of excite- 
ment, amounting to inflammation. They difFer also, it is be- 
lieved, in their tendency to affect the mucous membrane of one 
organ more than that of another. There are reasons for believ- 
ing that some articles of the class impress the urinary more de- 
cidedly than the bronchial, uterine or gastro-enteric mucous 
membrane. 

The benefit derived from this class is sometimes exhibited in 
the membrane itself when diseased, but frequently it is acted on 
when healthy to affect contiguous parts through its connection 
with them. For example, when the kidneys, bladder or uterus 
are in a state of inertia^ their activity may be restored by ex- 
citing the mucous memorane, and thus establish vigor in the 
whole organ through contiguity of structure. 

The membrane itself is also the subject of disease, and requires 
the action of excitants in its restoration. Even after acute in- 
flammation, a state of relaxation and debility ensues, which is 
relieved by exciting increase of activity. 

Ordinary chronic inflammation and ulceration are generally 
benefited by these elective excitants. In typhoid fever, disturb- 
ance of the alimentary lining membrane is of common occur- 
rence, and the appearance of the tongue will generally indicate 
the character or degree of irritation sufficiently to decide as to 
their applicability. If red and firey, we have evidence that the 
excitement is already too high, and are admonished to refrain 



AND THERAPEUTICS. 277 

from the use of such means; but if dark or pale, and accompa- 
nied with diarrhoeal discharges, the condition of the canal is 
likely such as to require their use. 

Catalogue of Blennymenal Stimulants. 

Oleum Terebinthinae, Eucalyptus, 

Copaiba, Collinsonia, 

Balsamum Tolutanum, Ammoniacum, 

Balsamum Peruvianum, Phellandrum Aquaticum, 

Senega, Styrax. 

Oleum Terebinthin^: — Oil of Turpentine. 

This is obtained by distillation from the oleoresin which ex- 
udes from the bark and wood of Pinus Pahcstris, and other spe- 
cies of Pinus, and described under the head of rubefacients. It 
is now considered only in connection with its action as a blenny- 
menal stimulant. 

The action of spirit of turpentine upon the mucous membranes 
generally is very decided and conspicuous. The urinary appa- 
ratus is painfully excited by full doses of the remedy, even when 
in a normal condition; and when affected with acute inflamma- 
tion, serious aggravation of tl*e symptoms occurs. The same 
may be said of its action upon the alimentary mucous membrane 
during the existence of boAvel affections. In acute enteritis, 
which may generally be determined in part by redness of tip 
and edges of the tongue, the remedy proves injurious; and even 
in chronic inflammation of the alimentary mucous membrane, 
when the tongue exhibits the appearance just mentioned, turpen- 
tine will not be tolerated. 

It has been greatly lauded by practitioners in the treatment of 
typhoid fever, without regard to symptoms or circumstances. 
It will be found, however, that without attention to the evidences 
of excitement in the canal, such as above given, great injury may 
result from its use. In this fever there is tendency to irritability 
of the mucous membranes generally. 

In the bronchia it is of frequent occurrence, and when of an 



278 ACOLOGV 

indolent character, the action of this remedy may prove benefi- 
cial. A relaxed condition, with copious discharge from the 
tubes, is not uncommon in this disease, and is the condition 
suited to the favorable action of turpentine. 

Iii gonorrhoea] inflammation, after the acute stage lias passed 
away, and an unhealthy, debilitated state of the urethra exists, 
the stimulus of this remedy is effectual in arresting the copious 
discharge which is found under these circumstance 

The dose, as a blennymenal stimulant, is from fifteen to twenty 
drops, made into emulsion with gum or sugar, and taken three 
or four times a day. In this quantity, blennorrhoea of some 
months' standing has been entirely relieved by it. When such 
discharge results from chronic inflammation of the kidneys, it is 
perhaps the best means of relief. 

Copaiba — Copaiva. 

An oleoresin, which exudes from Copaifera Multijuga, and 
other species of copaifera, stately trees found in various pro- 
vinces of South America. Balsam copaiva, as sometimes though 
improperly called, is obtained by making incisions into the trunk 
and branches of the tree. 

It is about the consistence of olive oil, of peculiar odor, pun- 
gent, unpleasant taste, and consists principally of oil and resin. 
The medicinal effects of this remedy resemble those of turpen- 
tine, except that it is less exciting. The mucous membranes 
generally are stimulated by it, and that connected with the uri- 
nary apparatus may, by large doses, be excited to the degree of 
strangury and unpleasant heat along the course of the urethra 
and in the kidneys. 

It may be used in chronic inflammation of the mucous sur- 
faces in cases where the more exciting effects of oil of turpentine 
would be injurious. In gonorrhoea, for example, copaiva is 
used with impunity, and perhaps advantageously in the most 
excited stage of the disease, when turpentine would not be tol- 
erated. 

The action is more of a soothing and local alterative stimula- 
tion than of irritation, and, in moderate quantity, may be found 



AND THERArEUTICS. 2?9 

useful in ordinary acute inflammation of the mucous membranes, 
by promoting healthy capillary circulation of the tissue. 

In chronic gastro-entritis the effects of this blennymenal stim- 
ulant is more decided in its action, and, when not offensive to 
the stomach, may be used with great advantage in the form of 
emulsion with gum arabic. While the mucilage soothes and 
protects the irritated surface, the ^opaiva comes in direct contact 
with the membrane to be acted on, without having to enter the 
circulation. The tardiness of absorption in such condition of 
the stomach, so far from interfering with the action, actually fa- 
cilitates it, by allowing the remedy to come in contact with the 
diseased surface as it passes through the stomach and bowels. 
The dose is from a half to one fluidrachm, given alone or in the 
form of emulsion with gum arabic or sugar. 

Oleum Copaibce — Oil of Copaiva — is obtained from copaiva by 
distillation. Its effects upon the mucous membranes are the 
same as those produced by the oleoresin, from which it is ob- 
tained, and may be used for the same purposes in half the quan- 
tity, or less, say from ten to thirty drops. 

Balsamtjm Tolutanum — Balsam of Tolu. 

The concrete juice obtained by incisions made in the trunk of 
Myrospermum Toluiferum, a tree found near Tolu, in Cathagena. 
This balsam, when fresh, is somewhat soft and tenacious, but 
becomes hard and brittle by exposure. It is of a yellowish 
brown color, aromatic, pleasant odor, and pungent, agreeable 
taste. While balsam of tolu possesses the faculty of exciting 
the mucous membranes generally, it is supposed to act more es- 
pecially upon the bronchial surfaces. Its effects, however, are 
less decided than those of the terebinthinates already described. 

In medicine it is used only as an exciting expectorant, making 
a useful ingredient in cough mixtures intended to relieve slight 
affections of the bronchia, etc. For the treatment of catarrh 
chronic bronchitis, or any affection of the respiratory organs 
not attended with high inflammatory action, a mixture composed 
of some preparation of tolu, simple syrup, or syrup of squills, 
opium and mucilage, allays the irritation upon which the har- 



280 ACOLOGV 

assing cough depends. Tola may be given in substance in the 
do» of twenty grains in the form of emulsion. 

Tim-turd Tohdanum — Tincture of Tobu — is the mosl convenient 
form for administration, particularly for fluid cough mixtures, 

in which this balsam forms an Ingredient. The doee is abovt one 

jlnidrachm, three or four times a day. 

Balsamum Peruvian i \\i — Balsam of Peru. 

The prepared juice obtained by incisions made in the bark of 
Mijrospermuni Pcruiferiun, a beautiful tree, found in Central 
America, and now being grown in the West India islands. 

Balsam of Peru is about the consistence of honey, of yellow- 
ish-brown color, fragrant odor and not unpleasant taste, leaving, 
when swallowed, a prickling sensation in the throat. 

The medicinal virtues of this balsam do not differ materially 
from those of the preceding article. Like it, the most prominent 
effect is manifested in the respiratory mucous membrane, andj 
like all others of the class, impresses the mucous tissue wherever 
found. The dose is twenty to thirty drops, given in the form of 
emulsion. 

Senega — Seneka. 

The root of Polygala Senega, an annual plant, ten or twelve 
inches high, with perennial root, irregularly branching, rough 
and tortuous. In the cortical portion reside the virtues of the 
root, the internal ligneous structure being inert. 

Seneka snakeroot, as this drug is sometimes called, has not been 
heretofore recognized as a general blennymenal stimulant. Its 
effects, however, on all the principal organs which have mucous 
membranes are known and admitted. The respiratory, uterine and 
urinary systems are excited by it. Hence, seneka is considered an 
emmenagogue, expectorant and diuretic of the stimulating vari- 
ety. Moreover, the fact of its having exciting influence upon 
the alimentary mucous membrane has been well established. It 
is said to be, "in large doses, emetic and cathartic." These re- 
sults of its action on the canal are doubtless produced by the 
physiological excitement given the lining membrane, which, 



AND THERAPEUTICS. 



281 



Fig. 2G. 



from moderate doses, is not sufficient to bring about decided con- 
traction of the canal. 

Practical benefit is derived 
from classifying this and other 
remedies according to the direct 
physiological action they pro- 
duce. Give this article, for ex- 
ample, according to the usual 
classification of the remedy, as 
an "expectorant," and in many 
cases when expectoration is de- 
ficient, the difficulty will be in- 
creased. In the usual classifica- 
tion, it is a prominent "emmena- 
gogue" and "expectorant." Sup- 
pose the functions to be promoted 
.by it are deranged from a phlo- 
gotic condition of the organ; 
would not the difficulty be in- 
creased, and the functions suffer 
still further derangement by this 
remedy, which, by exciting the mucous structure connected with 
the organs, causes an increased flow of blood to them ? When 
found, however, in a class, the name of which indicates the di- 
rect physiological effects to be expected from it, nothing would 
be more natural than -to use it to promote the functions above 
mentioned, when the difficulty in their performance depended 
on a want of sufficient excitement in the organs, and to withhold 
it when the opposite condition exists. 

Seneka is much esteemed in pneumonia and other pulmonary 
diseases, after the decline of inflammatory excitement, when an 
enfeebled condition of the organs, and general debility exists. 
Whether expectoration be increased or lessened, the gentle stim- 
ulus given to the mucous surfaces of the respiratory apparatus 
tends to restore that healthy vigor necessary to the proper func- 
tion of the organ. The same may be said of its use in diseases 
of other organs having the tissue upon which this elective action 




Polygala Senega. 



282 ACOLOGV 

is exerted. It is an efficient emmenagogue when menstruation is 
suppressed on account of an exsanguineous condition and want 
of excitement in the eterus. Jt acts as a diuretic in a similar 

condition of the kidneys. 

Seneka may be given in substance in the dose of fifteen to twenty 
grains, three times a day, or more frequently in the debility of 

acute disease, but in less quantity. 

Decoctum Senegce — Decoction of Seneka — is a common extem- 
poraneous preparation, and may be given in the dose of two fluid- 
ounces three times a day, or half a fluidounce every two hours. 

Extraction Senegce — Extract of Seneka — is a concentrated pre- 
paration, and has the advantages of convenience of administra- 
tion and freedom from unpleasant taste, as it can be readily made 
into pills. The dose is two or three grains. 

Syrupus Senegce — Syrup of Seneka. This is a pleasant prepa- 
ration, and one well adapted to the treatment of pectoral dis- 
eases requiring the action of this remedy, on account of the sooth- 
ing influence of syrup within itself in irritable eonditions of the 
air passages from sympathy of continuity. The dose is two or 
three fluidsrachms. 

Eucalyptus — Blue Gum. 

The leaves of Eucalyptus Globulus, or Blue Gum tree, a tall, 
evergeen tree, found abundantly throughout Australia and Van 
Dieman's Land and recently cultivated in Europe. 

The leaves emit a fragrant, balsamic odor, impregnating the 
air of eucalyptus forests, which enthusiasm for the remedy has 
perhaps magnified into an imaginary prophylactic against the rav- 
ages of malarial fever. 

Two important active principles are found in the leaves, viz: 
a fragrant, balsamic volatile oil, and a bitter resinoid substance. 
These have very different medicinal properties. According to 
the experiments of M. Fernand Papillon and others, the physi- 
ological action of the essential oil is that of blennyinenal stimu- 
lation, giving increased excitement of the mucous membranes 
generally, and to the organs with which they are connected, 



AND THERAPEUTICS. 283 

while the bitter principle gives tone to the spinal nervous centre, 
and consequently relief from malarial fevers. 

Oku hi Eucalypti — Oil of Eucalyptus — "is a limpid, almost col- 
orless fluid, of fragrant, aromatic odor, resembling somewhat 
that of camphor, and boiling at 170° cent." (306° Fahr.)— [Pa- 
cific 3Ied. &' Surg. Jour.) 

The fresh leaves -are found to yield about 2.75 per cent, of the 
oil, while more than 6 per cent, is obtained from recently dried 
leaves. (J/. Cloez.) 

The oil, being a stimulant to the mucous membranes, has been 
used successfully in the treatment of blennorrhoeal discharges 
from the respiratory, urinary and uterine organs, dependent upon 
the relaxation, irritation, and debility consequent upon chronic 
inflammation of the lining mucous membranes. The dose is 
about twenty drops in the form of emulsion. 

Eucalyptus has recently attracted the attention of therapeu- 
tists, and we predict for it a prominent place in the catalogue of 
remedial agents. 

Collinsonia — Heal-All. 

The root of Collinsonia Canadensis, an indigenous herbaceous 
plant, about two feet high, growing w 7 ild in various parts of the 
country from Canada to the Carolinas. 

The active principle being volatile, the fresh root is consid- 
ered preferable, and for the same reason the decoction is objec- 
tionable. 

An Infusion, made by pouring a pint of boiling water on half 
a troyounce of the bruised fresh root, may be used in the dose of 
two to four fluidounces three times a day, in catarrh of the blad- 
der, bronchorrhoea, leucorrhoea, etc., from chronic inflammation 
of the mucous membranes lining the various surfaces from which 
these mucous discharges emanate. 

Being an excitant of the mucous membranes, collinsonia may 
prove ineffectual and even injurious in acute inflammation of the 
mucous surfaces, and should therefore be used only in relaxed 
and enfeebled condition, from long-continued irritation and dis- 
turbance of the capillary circulation. 



284 ACOLOGY 

A mmoxiacum — A mmoniac. 

The concrete exudation from the stem of Dorema Afiimonior 
cum, an umbelliferous plant, six or eight feet high, growing 

abundantly in several provinces of Persia. 

Ammoniac is in yellowish brown tears and masses, of pe- 
culiar odor, and bitter, somewhat acrid, taste. It is partially 

soluble in water and alcohol. 

This drug, though much less used than formerly, is said to pos- 
sess properties somewhat similar to those of seneka. It evidently 
excites the mucous membranes, and while usually classed as ex- 
pectorant. only, may be found useful as a stimulant to the mucous 
membranes generally in blennorrhcea from rilaxation and debil- 
ity of the circulating vessels of the part. In similar conditions 
of the uterus, bronchia, and urinary organs, it will probably be 
found alike useful. Ammoniac may be given in substance in 
the form of emulsion or pill, in the dose of about twenty grains. 

Phellandrium Aquaticum — Water-Hemlock. 

The seeds of this plant, though not officinal, doubtless possess 
virtues which may be made useful in the treatment of disease. 
The usual stimulant effects upon the mucous membranes, had by 
other articles of this class, may be expected of this remedy, but 
it is not sufficiently well known to decide upon its value com- 
pared with those already mentioned. The seeds may be given 
in substance in the dose of two or three grains. 

A Tincture has been prepared, of which about one fluidrachm 

is the dose. 

Styrax — Storax. 

This is now recognized as the prepared juice of Liquidambar 
orientate, but heretofore known as the balsamic exudation from 
the branches of Styrax officinale, a small tree, fifteen or twenty 
feet high, a native of Syria, and naturalized in Spain and other 
countries. 

Liquid Storax, as found in market, is considered unfit for use 
until purified by dissolving in alcohol and evaporating to a- solid 
consistence. 



AND THERAPEUTICS. 



285 



Storax, though not extensively used at present, is known to 
possess sensible and medicinal properties similar to Peruvian 
balsam, and has been given with benefit in diseases of the ure- 
thral and bronchial mucous 

« Fig. 27. 

surfaces. 

In the form of fumes, it has 
been inhaled for its effects in 
bronchial affections; and in the 
dose of fifteen grains, adminis- 
tered by the stomach, for its 
general elective blennymenal 
impression. 

Storax somewhat resembles 
benzoin in some of its sensible 
and medicinal properties, and 
has been supposed to have some 
connection with it in botanical 
origin. These substances are 
associated in the compound tinc- 
ture of benzoin, a preparation 
found useful in chronic dysen- 
tery, catarrh, etc. 

Other articles may be mentioned, which, in some degree, act 
as blennymenal stimulants, but not enough is known of them to 
warrant a prominent place in the class. 

Naptha, benzoin, asclepias and Dracontium have been found 
useful under circumstances which prove their stimulant action 
upon the mucous membranes; but not having occupied a prom- 
inent place as stimulating "diuretics" or "expectorants," per- 
haps do not produce very powerful blennymenal stimulation. 




Sty rax officinale. 



280 ACOLOGY 

DIVISION IV. 

REMEDIES THAT A.PPECT Till; NERVOUS SYSTEM. 

This is perhaps the most important division of remedies to be 

found in the study of acology; not only on account of the large 
number of classes it contains, but from the universally control- 
lino- influence exerted by the system of organs upon which they 
act. The articles included in this division are called neurotics, 
and have been divided by authors into classes which receive 
names according to some symptom of their effects, without re- 
gard always to their primary direct influence. For instance, 
the term "narcotics" has been applied to certain agents, and is 
still known as the name of a prominent class, the articles of 
which lead to narcotism only as a secondary effect or result of 
their primary action. In order to preserve that system in nom- 
enclature which is necessary to impress the learner with the phy- 
siological action of remedies, we think they should be named 
"cerebral stimulants/' in accordance with the primary effect; 
because the first physiological change produced by the class called 
"narcotics" is that of cerebral excitement or stimulation. The 
same may be said of "antispasmodics," the name given to a class 
on account of the supposed control of spasms, which is only an 
occasional result of their action as a stimulant to the spinal nerves. 
This, in order to convey a definite idea of the direct effect 
should be named in accordance with the physiological action 
produced — the stimulation of the spinal cord. An imperfect 
knowledge of the complications of the nervous system, and of 
the different actions of remedies upon it, tends naturally to the 
errors alluded to ; but as the progress of science discloses new 
facts, appropriate terms should be substituted for those known 
to have originated in error. It is no valid objection to say that 
a multiplicity of terms leads to confusion. This is more likely 
to result from retaining those in direct contradiction of recently 
established facts. Such names, then, as impress the truths 
sought to be inculcated, and that favor the progress of rational, 
practical medicine should be adopted. Indeed, physiological 



AND THERArEUTICS. 287 

classification exists in the recognition of direct primary action, 
and necessarily requires names for the classes differing entirely 
from those of a classification founded on therapeutic results. 

CLASS I. 

CEREBRAL STIMULANTS. 

The remedies of this class, while they exert a general influence 
indirectly, act directly upon the nervous centre within the cra- 
nium alone. Being a central organ of the great controlling 
nervous system, of course all parts of the body are affected by 
any modification of its functions. To the proper amount of ner- 
vous influence, is healthy action of the whole organism due. 

Derangement of the general nervous energies is often the 
result of deficient nervous influence, while some particular organ 
may exhibit more decided evidences of depression, and may be 
restored by cerebral stimulants. Moreover, the derangement of 
the general nervous system from local organic disease, causing 
reflex influence from the nervous centres, may be temporarily 
allayed by exciting the brain to increased energy, so as to afford, 
for the time, an increased amount of nervous fluid, by which the 
local irritation is resisted, and the nervous influences established. 

In this way hysteria, and other forms of reflex nervous dis- 
turbance, are temporarily quieted by cerebral stimulants. In 
like manner general irritability of the nervous system, and pain- 
ful condition of any part, from injury or other cause, may be 
allayed. Local irritation of any of the soft structures, which 
often results in inflammation of the part, is favorably impressed 
by cerebral stimulants. 

This class, as before intimated, is generally known as " nar- 
cotics and nervous stimulants." But, while narcotism and gen- 
eral nervous energy are the results of their action upon the brain, 
these ultimate or indirect effects are by no means the primary 
and direct action of these remedies. 

The classification that seems best adapted to the study of 
rational medicine is based upon their physiological action, and 
the names given to the several classes are understood to denote 



288 ACOLOOY 

that action. Hence, inasmuch as the known physiological, di- 
rect and primary action of the articles included in this class 
is that of stimulation of the brain, the proper name of the class 
is that which we have adopted. The author has not originated 
the change, if an innovation in nosology it may be called. The 
learned Dr. George B. Wood, than whom no more accurate 
thinker has written on materia mediea, used this term thirty 
years ago in connection with the class under consideration. 

Narcotism is one of the secondary and unpleasant effects of 
these remedies, but should not by any means be entitled to such 
importance as to give name to the class. The stimulation to the 
nervous system generally is, of course, a consequence of the phy- 
siological action upon the centre of that system, and does not 
consist of direct impression upon the nerves themselves. 

The remedies of this class have also been called " anodynes," 
and properly too, when reference is had to their therapeutic 
effect. Relief of pain in any part is the result of action had 
upon the brain, as we have said, but this relief is not afforded 
by the direct or elective influence on the painful part. It can- 
not, therefore, in a physiological classification, be recognized as 
the direct action of the remedy. We have learned from ex- 
perience that cerebral stimulation leads to anodyne influence 
upon the nervous system generally in the manner before de- 
scribed, and therefore recognize the result or therapeutic effects 
by the terms " anodyne, antispasmodic," etc. 

Cerebral stimulants are considered palliatives only, by many 
who prescribe them, and hence are not relied on for any curative 
influence. That temporary relief alone is all that can reason- 
ably be expected in many instances"in which they are used, is 
certainly true, but it is equally so that, were it not for the invig- 
oration afforded to the brain, the vital energies of. the system 
could not be sustained through protracted violent disease. More- 
over, noxious influences upon the nervous centres, such as pois- 
onous vapors, etc., which ultimately exhaust themselves and 
cease to disturb the nervous functions, would more frequently 
prove fatal but for the timely and constant use of cerebral stim- 
ulants. These sustain the functions of the brain till the effects 



AND THERAPEUTICS. 289 

of the poison have passed away. Life itself is in this way pre- 
served, when no antidotal or permanent impression is at any 
time made by the remedy. Many known material agents thus 
affect the brain, and would destroy life without this artificial ex- 
citement afforded the organ. 

Unknown causes operate upon the nervous system in the same 
manner and lead to a train of symptoms in which fever is prom- 
inent. "The fever" is a term applied to febrile manifestations 
of certain morbid impressions upon the nervous system, and the 
descriptive appellations, typhoid, yellow, remittent, etc., are pre- 
fixed to denote various characteristics, which depend upon the 
different qualities of poison taken into the system, and the dif- 
ferent portions of the nervous centres disturbed by them. When 
the brain itself, or that portion of the nervous centres in the cra- 
nium, is the part upon which a poison exerts its elective action, 
more constant is the fever, and greater the tendency to general 
and complete prostration of the vital energies. Under such cir- 
cumstances, cerebral stimulants and tonics form the sheet anchor 
of treatment. 

Catalogue of Cerebral Stimulants. 

Opium, Stramonium, 

Chloroformum, Belladonna, . 

Alcohol, iEther, 

Hyoscyamus, Cannabis Indica. 

Opium. 

The concrete exudation from incisions made in the capsules of 
Papaver Somnijerum, or common poppy, an herbaceous plant, two 
to four feet high, and cultivated in various parts of the world 
for the beauty of its flowers, for the opium obtained from the 
capsules, and for the oil of the seed. 

There are two varieties of the poppy, named from the color of 

the seeds. The white poppy has large capsules, affording greater 

amount of the juice, and therefore cultivated for the opium 

which it yields. It has white flowers, and whitish colored seed. 

19 



290 



ACOLOGY 



The black /><>/>i\i/ bas black >vn\, and red, white and variegated 
flowers. This variety affords opium perhaps equal in quality, 
but owing to the small size of 
the capsule.-, the quantity ob- 
tained will not warrant its cul- 
tivation for this purpose. 

The process of making opi- 
um is simple, and requires very 
little art, ingenuity or experi- 
ence. The pods or capsules, at 
the time of shedding the flow- 
ers, are cut with superficial 
longitudinal incisions. From 
these exude a milky fluid which, 
after remaining twelve to twen- 
ty-four hours, is scraped from 
the surface, and placed in an 
airy, shady situation to dry. 
It may then be packed away, 
and is ready for use. 

Opium has a bitter, unpleas- 
ant taste, dark- brown color, and 
narcotic odor. It is of the proper consistence for making pills, 
and may be administered in this way without other preparation. 

Opium, in point of importance, stands properly at the head 
of cerebral stimulants. In bringing about the therapeutic ano- 
dyne effect so desirable in painful conditions, its action upon the 
brain is prompt and effective. The whole mass of the organ 
seems to be excited by it. Scarcely a function of these centres 
within the cranium escapes the exciting influence of the remedy. 

The symptoms of its primary effects are flushed face, increased 
activity and exhilaration of the mental faculties; those of the 
secondary are stupor, headache, nausea, etc. The unpleasant 
secondary effects may be greatly palliated by the use of acid 
fruits or drinks. The manner in which the anodyne effect of 
opium is brought about, upon certain painful or irritable parts, is 
not very well understood. It is evident that sensation or per- 




Papaya Somniferwn. 



AND THERAPEUTICS. 291 

oeptiOD by the brain of a local injury or irritation is not so dis- 
tinct under the influence of this drug; nor is the pathological 
reflex nervous action that results from chronic inflammation or 
other local cause so prominent. May not, then, the additional 
amount of nervous fluid passing out from the brain, under the 
action of this stimulus, retard the return of impressions along 
the nerves of sensation to the brain ? Thus, the nervous fluid 
may interfere with perception from its own accumulation, and 
allay irritation by affording sufficient nervous power to reestab- 
lish healthy capillary circulation in the diseased part. In this 
way the sensation of pain may be lessened, and the increased 
excitement of the part, to a considerable extent, prevented. 

Opium arrests excessive discharges from the bowels, and even 
leads to constipation in a healthy condition of the organs. This 
effect so nearly resembles that of astringents that a similar prop- 
erty has been attributed to the drug. This, however, does not 
seem to be the case. It has the peculiar power of suppressing 
the follicular secretion constantly poured out upon the mucous 
membrane of the alimentary canal, as shown in the dryness of 
the mouth, throat and hardened fseces while under its influence. 

Doubtless the exhalation or transudation into the bowels of 
the watery constituents of the blood is also interfered with, while, 
as a kind of vicarious depuration, the cutaneous transpiration is 
promoted by it. In this way, lubrication of the alimentary 
canal is prevented, the consistence of the contents increased, and 
alvine evacuations restrained. 

While irregular spasmodic contractions of the bowels, exhib- 
ited in the tormina of enteric affections, is allay ed by the ano- 
dyne effect of opium, in the manner described above, it is certain 
that the natural peristaltic contraction of the muscular coat is 
not arrested by it, as evidences of these movements in health 
are quite perceptible while under its influence. The extraordi- 
nary contractions from the irritation of disease or cathartic rem- 
edies are doubtless restrained, the secretion and exhalation of 
fluids into the canal suppressed, and to these changes perhaps 
alone are the constipating effects of opium due. 

The cutaneous transpiration so perceptibly increased by opium 



292 ACOLOGY 

seems to be, as just stated, a kind of vicarious discharge for the 
enteric exhalation. Hence opium, as justly as any article in 
the Materia Medica, may be ranked as a diaphoretic. And 

while we do not think that this or any other article in our 
knowledge has any direct influence over the follicular secretion 
or transpiration of the skin, yet in the modification of the cap- 
illary circulation in it, and of the circulating fluid itself, 
produced by neurotics, diluents, nauseants, etc., cutaneous exha- 
lation is often greatly increased. This discharge is promoted by 
opium when, from feeble circulation of the capillaries, it is defi- 
cient; for a prominent result of cerebral stimulation is an in- 
creased activity of the cutaneous circulation, as is exhibited in 
the flushed face and general warmth of the surface. Increase of 
nervous power is thus shown to induce more active peripheral 
and capillary circulation. 

Irritability being one of the main constituents of inflamma- 
tory action, opium, by its control of this, in a good degree, is a 
valuable antiphlogistic, particularly when situated in the mucous 
membranes. It is therefore useful in mucous enteritis, on ac- 
count of the constipating influence, and anodyne, soothing effect 
upon the irritable, inflamed surface. In nervous exhaustion, and 
prostration from the shock of violent injury or exhausting dis- 
ease, this cerebral stimulant gives valuable support. 

Adynamic fevers, which doubtless depend upon primary de- 
pression of the cranial nervous centres, are restrained, in their 
exhaustive effect upon the nervous energies, by the regular use of 
opium. Its daily administration not only allays the irritation of 
the bowels so common in typhoid fever, but keeps up, to some 
extent, the necessary activity of the brain during the time of its 
usual course. It is believed that, by its timely use, much of the 
structural lesion in the alimentary and bronchial mucous mem- 
branes may be avoided. The capillaries of these parts are prone 
to derangement on account of deficient nervous influence from 
the depressed condition of the nervous centres involved in the 
primary disturbance of this disease, and this leads to structural 
lesions in the form of ulceration, etc. 

It is only in the cold or congestive stage of malarial fevers 



AND THERAPEUTICS. 293 

that opium is specially useful, and then does no more than 
shorten this particular stage. In malignant intermittent fever, 
the congestion is so complete and protracted that reaction some- 
times fails to occur. Under such circumstances, this, with other 
cerebral stimulants, are relied on to arouse the nervous energies 
sufficiently to reestablish the peripheral circulation. Life may 
sometimes be preserved in this way, when otherwise a fatal term- 
ination would be inevitable. 

Opium may be given in substance, in the shape of pill or elec- 
tuary, in the dose of one grain. When not too dry from expo- 
sure, it is sufficiently adhesive, and makes a very suitable mass 
for pills. 

The active principles of this drug, the most important of which 
are morphia, narceia, and opiania, are obtained separately, and 
used in the form of salts made by combinations with different 
acids. 

Svapnia, the name given by Dr. Bigelow to a preparation of 
opium made by himself, is said to contain the useful active prin- 
ciples, without the narcotine and others having unpleasant taste. 
The dose is one grain. 

Morphine Acetas — Acetate of Morphia — as found in the shops, 
is a light-brownish powder, the very fine crystals having lost 
their form. This preparation of morphia is in very general use, 
and on some accounts preferable to other salts of morphia. While 
its acetic combination may, to some extent, prevent the unpleas- 
ant secondary effects of morphia, the form is more convenient 
for dispensing than the light flocculent sulphate. It may be 
taken in solution, or, by placing the salt upon the tongue, where 
it readily dissolves by the moisture of the mouth, and passing 
down the oesophagus, its absorption is in part effected before 
reaching the stomach. In this way it is more rapidly taken into 
the circulation than when dissolved and carried at once to the 
stomach, particularly when a meal has just been taken, with 
which the solution mixes, and comes slowly in contact with the 
gastric mucous membrane. The endermic application to a blis- 
tered surface allows absorption to a limited extent, and in this 
way the nervous centre may be sufficiently impressed by the 



294 ACOtOGV 

remedy. The most effectual and practical mode of administering 
any of the Baits of morphia, however, is the hypodermic applica- 
tion. With a syringe for the purpose, a concentrated solution 
may be injected beneath the skin without difficulty, when i( per- 
meates the cellular tissue, is dissolved and rapidly absorbed. 
The effect of morphine is more rapidly produced in this way 
than even by taking it undissolved in the mouth. Nausea, head- 
ache and other unpleasant secondary effects of opium are thought 
to be less troublesome when it is used in this way. A perfect 
solution should be made, however, in order to prevent the local 
irritation which is liable to result from undissolved portions of 
the salt-remaining in the cellular tissue. This is effected by the 
addition of a drop of acetic acid, or two or three drops of vine- 
gar, to a fluidrachm of water, in which two grains of the acetate 
of morphia are dissolved. The solution, which at first looks 
muddy, at once clears and becomes transparent when the acid is 
added. The dose, when taken by the mouth or hypodermic in- 
jection, is one-fourth of a grain; and of the solution just de- 
scribed, six or eight drops make the proper quantity to be injected. 

Morphkv Sulphas — Sulphate of Morphia — has been in more 
general use, until recently, than any of the salts of morphia. It 
is in needle-like crystals, forming a light flocculent mass, of white 
color, and is more soluble in water than the acetate. The gen- 
eral effects are about the same as the last mentioned preparation, 
with the exception of the supposed advantage possessed by the 
acetate, in the comparative freedom from unpleasant after-effects 
of the remedy. 

Morphias Marias — Muriate of Morphia. This is in the form 
of white flocculent crystals, resembling somewhat that of the 
sulphate. The properties and dose are the same as this salt, and 
though very seldom used in this country, may be given in the 
same dose and for the same purposes. 

Tinctura Opii- -Tincture of Opium — as the name implies, is a 
solution of the active principles of the drug in alcohol. Pure 
alcohol, however, not being a perfect solvent of all the active 
principles of opium, diluted alcohol, the mixture of equal por- 
tions of alcohol and water, is used for this tincture. The dose 



AND THERAPEUTICS. 295 

of laudanum, a name by which the tincture is familiarly known, 
is about twenty-five drops. 

Water dissolves only a part of the active ingredients of opium, 
leaving in the residue some of the principles which produce nau- 
sea, and other unpleasant secondary effects, and hence the watery 
extract of opium is comparatively free from them, particularly if 
exhausted of narcotina by ether. 

Denarcotized Opium is the extract thus prepared, and may be 
used in half the quantity of opium, say half a grain for the dose. 

Denarcotized Laudanum is simply a tincture of the extract 
thus deprived of narcotina, and is known officinally as 

Tinctura Opii Deodorata — Deodorized Tincture of Opium. This 
will be found sufficiently free from narcotina, and other princi- 
ples which affect unpleasantly persons with idiosyncrasy against 
opium, to make it acceptable. The dose is ticenty to thirty drops, 
or about the same as simple tincture of opium. 

McMunn's Elixir of Opium is said to differ from the deodor- 
ized tincture only in having less alcohol in its preparation, and 
perhaps more thorough exhaustion of the odor and narcotina of 
the crude opium. 

Tinctura Opii Acetatis — Acetated Tincture of Opium — was. once 
a popular preparation, and doubtless is followed by less headache, 
stupor, etc., than the simple tincture. This may be in part ow- 
ing to the controlling influence acetic acid is supposed to exert 
in preventing and allaying these symptoms. The dose is about 
ticenty drops. 

Tinctura Opii Camphor ata — Camphorated Tincture of Opium — 
Paregoric. This preparation contains carminative and soothing 
ingredients, which add greatly to its anodyne effect. On this 
account a less quantity of the active principles of opium is re- 
quired in the control of nervous derangement than is necessary 
to induce the narcotic symptoms. To children, therefore, and 
those unpleasantly affected by other preparations of opium, pare- 
goric may be advantageously administered. Half a fluidounce 
contains the strength of less than one grain of opium, but this 
quantity of the tincture is equal in its anodyne effects to a larger 
amount of the crude drug. 



296 acolo' 

( 'iiloroformum — Chloroform. 

Chemically, this is the terchloride of formyl, a colorless, heavy 

volatile liquid, of agreeable odor and plea-ant taste. Unlike 
mosl other volatile Liquids, chloroform is very heavy, having the 
specific gravity of 1.49 j and, when poured into water, falls in 

transparent globules to the bottom of the vessel without mixing 
at all with that liquid. A test is thus afforded of its purity, the 
water becoming milky when the remedy is not of proper quality. 

Chloroform is a prompt and powerful cerebral stimulant, giv- 
ing that amount of nervous energy necessary to control pain, 
irregular* spasmodic contractions, congestion, etc. So decided 
and prompt has it been found iu giving relief to the last named 
condition that chloroform is by some considered a curative rem- 
edy in intermittent fever. The conclusion arrived at, however, 
after systematic investigation on this subject, is, that the cold 
stage may be shortened — indeed, arrested at once — but that the 
paroxysms are liable to return at the regular period afterwards. 
In colic and other painful conditions of the bowels, chloroform 
is equal, and in some instances greatly superior, to opium. 

This cerebral stimulant has been considered the very best an- 
tispasmodic in puerperal convulsions, but although a valuable 
remedy in the disease, doubtless proves so by an action very 
different from that under which we are now considering it. We 
have already alluded, under the head of catalytics, to the recently 
suggested pathology of eclampsia of the puerperal state, and of 
the catalytic effect of chloroform in the prevention and cure of 
such convulsions. While it is possible that some restraining in- 
fluence may be exerted upon the spasm by the neurotic effect, it 
is not probable that anything more than slight temporary re- 
straint, such as is had from other cerebral stimulants, will be 
afforded by this action of chloroform.. In mania a potu, chloro- 
form proves to be an efficient remedy, but of its modus operandi 
there is ground for discussion. The true pathological condition 
leading to the production of such nervous derangement is not 
well settled. Some suppose the cerebral excitement so constantly 
kept up by alcoholic drinks leads to the mania in question, while 



AND THERAPEUTICS. 297 

others attribute the hallucinations to a sudden suspension of the 
accustomed stimulus. The latter seems most reasonable, since it 
is generally after the use of spirituous liquors has been sus- 
pended, being refused by the patient or rejected by the stom- 
ach, that such symptoms are developed. This theory of its pa- 
thology would make it reasonable to expect benefit in the treat- 
ment of the affection from the cerebral stimulation of this active 
remedy. On the other hand, it is difficult to imagine how a 
stimulant to an organ can relieve a condition dependent directly 
upon over-stimulation of the same part. The true theory no 
doubt is, that the brain, when constantly stimulated for a time, 
like all other organs thus preternaturally excited, fails to perform 
its ordinary functions when the stimulus is withdrawn, and re- 
quires the same or some other excitant judiciously administered. 

During the late war, chloroform was used, it is said, with ben- 
efit in that intractable disease, tetanus. Indeed, the experiments 
made with it by Dr. Joseph Jones, in the hospitals of Richmond, 
Virginia, would seem to justify the opinion entertained of its 
curative powers. One case at least recovered under its use, and 
the record of its symptoms and treatment is calculated to give 
confidence in the remedy. So rarely do confirmed cases recover, 
that whatever has been used in any terminating favorably is 
sought after with great anxiety, without regard to the known 
physiological action, or modus operandi of the agent. Chloro- 
form has the usual anodyne and vivifying effects of other cere- 
bral stimulants, and may be used in restlessness, neuralgia and 
other painful conditions. The dose is thirty to sixty drops, rubbed 
up with sugar or gum, and agitated briskly before taking. The 
difficulty of mixing chloroform with, or dissolving it in, other 
fluids, and its volatile character, render the administration some- 
what difficult. 

Chlorodyne, a preparation now substituted for an empirical 
chlorodyne of London, is composed of chloroform, oil of pepper, 
extract of cannabis, morphia and some other unimportant ingre- 
dients. In this mixture, the proportion of chloroform is too 
small for its full effect, being, in the dose designated, not more 
than fifteen or twenty drops. This, however, with the eighth of 



298 acoloc.y 

a grain <>f morphia, fche proportion id a dose of the preparation, 

insures a gentle anodyne effect, and answers very well for this 

purpose. 

Alcohol. 

This Liquid results from what is called vinous or alcoholic fer- 
mentation of saccharine substances, or those capable of being 
changed into sugar. In this process, which is conducted at a 
temperature of from 60° to 90° Fahrenheit, sugar is converted 
into alcohol and carbonic acid. The latter escapes in the form of 
gas, with a small portion of glycerine and succinic acid. Grapes, 
apples, peaches, and other fruits subject to fermentation, contain 
sugar, which is changed into the ingredients above named, in 
this process. Grain and potatoes, which contain starch and 
gluten, readily take on this fermentation and yield alcohol. 
These, however, require a double fermentation, or a change first 
from starch to sugar, which is called spontaneous change, or sugar 
fermentation. Thus it will be seen that, though alcohol may be 
made from substances which contain no sugar, yet before vinous 
fermentation occurs it must be present. In these fermented 
liquors alcohol exists in a diluted state, the larger proportion 
being water. They are named according to the fruits and other 
substances from which they are prepared. Thus the malt liquor 
from grain is called beer ; the fermented juice of the apple, cider; 
that which results from the grape, wine, etc. These liquors 
afford, by distillation, the various forms of ardent spirit soon to 
be mentioned as preparations of alcohol. 

Alcohol, being more volatile than water, passes over, on the 
application of heat to the still, comparatively free at first. 
Water, however, gradually vaporizes also, so that, in ordinary 
distillation, the spirit consists of water equal in amount to alco- 
hol. Ordinary alcohol is obtained by redistillation, and arrest- 
ing the process before a sufficient amount of water passes over to 
dilute it excessively. 

Perfectly pure, dry or anhydrous alcohol is obtained only by 
the addition of quick lime, which, having great affinity for water, 
leaves the alcohol free. 



AND THERAPEUTICS. 299 

Its specific gravity is 0.79, (U. S. D.) and in this state of con- 
centration or purity is seldom used in pharmacy, and never as a 
medical agent. 

Alcohol, called also Spiritus Bectificatus— Rectified Spirit — has 
a specific gravity of 0.85. It is used in the preparation of tinc- 
tures, and for various other purposes in pharmacy and the arts. 

Diluted Alcohol, or proof spirit, is made by mixing equal parts 
of alcohol and water, or by a certain process of distillation by 
which a spirit is obtained of about 0.91 specific gravity, water 
being 1. Alcohol and diluted alcohol are used only in phar- 
macy, and need no further notice in this place. 

The various diluted alcoholic liquors, such as brandy, whisky, 
rum, etc., having the specific gravity of about 0.95, and the fer- 
mented undistilled liquors, such as w T ine, beer, ale, etc., furnish 
the therapeutist with a valuable agent. Unfortunantly for hu- 
manity, however, they are the source of great misery in the land? 
from their intemperate use as a beverage. 

Alcohol, as a cerebral stimulant, differs in some respects from 
those already mentioned. While that portion of the braiu pre- 
siding over the mental faculties is excited more powerfully than 
by opium or chloroform, the organic system of nerves are by 
no means affected to the same extent. Hence the anodyne effect 
of brandy is inconsiderable compared with that of opium. 

In cases of adynamic disease, and powerful shocks to the ner- 
vous centres, its use is demanded in connection with other cere- 
bral stimulants, that a more thorough control may be exercised 
over the nervous energies. In typhoid fever, therefore, and in 
the cold stage of malignant intermittents, brandy or whisky be- 
comes necessary. They have perhaps no efficacy in warding off 
a paroxysm of congestive fever, but may be used to prevent that 
fatal nervous depresssion which sometimes ensues. 

Mental or physical exhaustion from excessive exercise, partic- 
ularly in warm weather, requires the use of spirituous liquors. 
While this is true, the use made of them to keep up the warmth 
of the body in cold weather is often injurious. Rich meat diet, 
in full quantity, will be found more successful for this purpose. 

The preparations of distilled spirit are, as has been said, named 



:;<>() aCOLOGT 

according to the fruii or grain Prom which they are obtained. 
Whiskies are made of rye, corn and potatoes; brandies^ of 
grapes, peaches and apples; and rtem, of cane sugar. Spirit 
made from -rain and rectified with juniper is called gm. Some 
of these are more acceptable and agreeable to the stomach than 
others. Generally, however, their purity and age have more to 
do in this respect than the particular variety of spirit. When 
of about 0.95 specific gravity, containing "about 50 per cent, of 
pure alcohol, the dose is two fluidounces diluted with water. 

The vinous or malt liquors, from which spirit is distilled, con- 
sist of port, madeira, teneriff and claret, as the principal wines; 
and ale, porter and beer, as the leading malt liquors. Some of 
these have other properties than that of cerebral stimulation. 
Hops, and perhaps other bitter tonic principles, are contained in 
them, which act as digestive tonics. Alcohol exists in these fer- 
mented liquors, and they prove as efficient cerebral stimulants, 
when given in full quantity, as distilled spirit diluted to the 
same degree. They also, from the carbonic acid gas retained 
in them, prove more grateful to the stomach than distilled 
drinks. 

In debility of the stomach, therefore, at the same time ner- 
vous invigoration becomes necessary, these preparations afford 
suitable means of relief. By them a delicate appetite is im- 
proved, and the activity of the stomach promoted. These fa- 
vorable changes are effected in the stomach, not only by the 
direct tonic influence upon the organ, but by increasing the ner- 
vous energies, which often decline under such circumstances, to 
the still further embarrassment of digestion. 

Wines have peculiarities of action, on account of the acid and 
astringent qualities which some of them possess. Port wine, 
for instance, contains an astringent principle which is some- 
times useful in connection with the alcoholic stimulation of the 
wine. 

Claret is a tart wine, and affords a grateful drink in febrile 
affections requiring stimulation. Wine may be given in the 
dose of about four fluidounces, ale porter and beer in double that 
amount. 



AND THERAPEUTICS. 



301 



Fig. 29. 



Hyoscyamus — Henbane. 

The leaves and seed of Hyoscyamus niger, an herbaceous bi- 
ennial plant, sometimes annual. The annual variety is smaller, 
and in other respects differs from the biennial, but is similar in 
medicinal properties. It is a native of Europe, but grows abun- 
dantly in many parts of the United States. 

Hyoscyamus is a cerebral stim- 
ulant, but less active and not so 
certain in its effects as opium. 
Unlike the latter article, it has no 
tendency to constipation, but, on 
the contrary, is somewhat laxa- 
tive in full doses. It also differs 
from opium in its effects on the 
pupil. While the latter dimin- 
ishes the size of the opening in 
the iris, hyoscyamus enlarges it, 
and is often used for the purpose 
by oculists. From these facts it 
must be inferred that entirely dif- 
ferent effects are produced upon 
the same part, or that different 
parts are affected by the two rem- 
edies. 

We have already noticed the difference between the action of 
chloroform, alcohol and opium, and attributed it to the particu- 
lar portions of the nervous centre upon which each acts. 

This may also account for the peculiarities of the drug under 
consideration. It is w T ell known that all of them increase the 
activity of certain functions of the brain. While some give in- 
creased energy to the mental faculties, to the extent of percept- 
ible exhilaration and even intoxication, others, more power- 
ful in their excitement to the nerves of organic life, seem not 
to affect the mind. 

Hyoscyamus acts as an anodyne in painful and irritable con- 
ditions of cancerous or other local disease, and in painful affec^ 




Hyoscyamus niger. 



302 ACOLOGY 

fcions dependent on derangement of tin- nervous system, such as 
gout, rheumatism, neuralgia, etc. In chronic affections, which 
require remedies constantly for a long time, opium and brandy 
lay the foundation for an uncontrollable, injurious habit. Under 
these circumstances, hyoseyamus, less objectionable in this par- 
ticular, should be at least occasionally substituted for them. 

The seeds of henbane are said to be more active than the 
leaves, and are given in somewhat less quantity. The dose is 
about jirr grains, in the form of powder. The leaves may also 
be used in substance in the dose of six or eight (/ruins. 

Extractiim Hyoscyami — Extract of Hyoseyamus. This is the 
most convenient solid preparation of the drug, and that which 
is generally used. It is of consistence suitable for pills, and in 
this form can readily be administered. The dose is about two 
grains, gradually inereased till the full effects are realized. The 
want of certainty and promptness in the action of any prepara- 
tion of henbane, owing to carelessness in its preservation and 
other causes, renders the increase absolutely necessary to its full 
action. 

Tinctura Hyoscyami — Tincture of Hyoseyamus. Like tinctures 
of most drugs, this is less liable to uncertainty of strength from 
improper preparation or deterioration from time than the extract. 
It is specially the case with this article. Hence, the tincture 
will probably be found more reliable. The dose is one fluidrachm, 
gradually increased to two or more. 

Stramonium — Thornapple. 

The leaves and seed of Datura Stramonium, or Thornapple, 
an annual plant, native of Europe, but found now in most parts 
of the United States. It is called Jamestown weed, and is said 
to have received this name from being first discovered in America 
at the old town of this name, on James River, Virginia. Stra- 
monium, as an anodyne for the alleviation of pain, is less effective 
than any article of the class, but is an active remedy, producing 
powerful impression on the nervous centre, amounting in over- 
doses to poisonous action, 



AND THERArEUTICS. 303 

In chronic painful affections, when there is a want of regu- 
larity and energy in the nervous influences, stramonium has been 
found useful. Mania, epilepsy and rheumatism are said to have 
been greatly benefited by it. When, with or without pain, the 
uterus fails to perform its function from irregular or deficient 
nervous energy, its activity may be promoted by this remedy. 
The seeds are more active than the leaves, and may be pulver- 
ized and given in the dose of one grain, two or three times a day. 
The leaves, when powdered, can be readily administered, in pill 
or electuary, in the dose of two or three grains. 

Extractum Stramonii — Extract of Stramonium, This may be 
given in the form of pill, in the dose of half a gram, and will 
be found the most convenient way of using the remedy in the 
solid form. 

Tinctura Stramonii — Tincture of Stramonium — is a convenient 
form for administering the remedy in a fluid state. Dose, half a 
jiiddrachm. 

Belladonna — Deadly Nightshade. 

The leaves of Atropia Belladonna, (Belladonnce Folia) and the 
root of Atropia Belladonna, (Belladonnce Radix) an herbaceous 
plant, native of Europe and cultivated successfully in the United 
States. While the physiological action of belladonna seems an- 
tagonistic, in some respects, to opium, the leading article in the 
class of cerebral stimulants, its powerfully exciting influence 
upon the brain is beyond question. Stramonium and hyoscya- 
mus have, to some extent, the same antagonism to opium and 
calabar bean, in their effects upon the pupil, which is so mani- 
festly the case with belladonna. 

That both opium and belladonna are cerebral stimulants, and 
that their antagonism and other peculiarities of action depend 
on the different portions of the nervous system acted on, there need 
be no better evidence required than the fact of neuralgia in certain 
nerves being under the control of opium, while in others bella- 
donna proves more effectual. Cranial neuralgia, cephalalgia, tic 
douloureux, etc., will sometimes be found to yield readily under 
the administration of belladonna^ while the disease in other parts 



304 ECOLOGY 

is speedily quieted by opium, temporarily. The peculiarity of 
belladonna on the erectile tissues seems to extend to the sphinc- 
ters generally. The <>s uteri, neck of the bladder, etc., are said 
to be under its influence. Hencej its local application to the 
mouth <>(' the womb in tedious labor, from a want of activity in 
the longitudinal fibres of the os and neck, is believed to be ben- 
eficial in hastening the delivery. It is also found to relieve in- 
continence of urine, probably by giving vigor to the contractile 
tissue of the neck of the bladder. Belladonna, though inferior 
to opium, chloroform, and perhaps hyoscyamus, as an anodyne, 
in the speedy relief of acute pain, yet, in neuralgia, strangury 
and other diseases in which it is useful, more permanent action 
may be expected. Like other cerebral stimulants, it is bene- 
ficial in local disease with great irritability of the part. The 
spasm consequent upon irritation of the rectum in dysentery is 
no doubt greatly benefited by it, and there are reports of its sal- 
utary influence by local application on the hypogastrinm. Oc- 
ulists find belladonna an indispensable agent in enlarging the 
pupil for surgical operations, and also to prevent its permanent 
obliteration in inflammation of the iris, from natural or traumatic 
causes. The dose of bellabonna, in the form of the pulverized 
leaves, is about two grains. 

Atropia, the active principle of belladonna, is a more conve- 
nient form for the local application of the remedy, particularly 
when used to enlarge the pupil. A drop or two of a solution of 
the sulphate placed on the conjunctiva will, in half an hour, 
produce this effect. It may also be used internally, with the 
same results as those obtained from the drug in substance, but, 
owing to the great activity of minute doses, other preparations 
are used for this purpose. The dose is one-thirtieth of a grain, 
gradually increased. 

Exiraetum Belladonnas — Extract of Belladonna. This prepa- 
ration of belladonna is most generally administered when the 
remedy is used in the solid form. The dose is one-fourth of a 
grain, and can be easily made into a pill of small size. 

linctura Belladonnce — Tincture of Belladonna — is a form 
adapted to fluid preparations in which belladonna enters. The 
dose is about twenty drops. 



AND THERAPEUTICS. 305 

JEther — Ether. 

This ether is obtained by distillation from a combination of 
alcohol and sulphuric acid, and is a transparent, very volatile 
liquid. Commercial or impure ether has the specific gravity of 
0.75, while the stronger or purified ether is only 0.72. 

The exciting effect of ether upon the brain is prompt, at the 
same time giving a glow of heat from the warmth communicated 
to the stomach before absorption occurs. It proves useful as an 
anodyne in colic, and other spasmodic conditions of the stomach 
and bowels. In paroxysms of hysteria, and other forms of re- 
flex nervous derangement, ether, by its speedy and powerful ac- 
tion upon the brain, gives temporary relief from general nervous 
derangement by the great increase of nerve force. Mixed with 
the tincture or some other liquid, or soluble preparation of opium, 
it affords a very convenient and effectual anodyne for the pur- 
poses above mentioned. 

The dose is one fluidrachm, diluted with water, and taken im- 
mediately after being poured out. 

It is referred to in another part of this work, under the head 
of anaesthetics. 

Cannabis Indica — Indian Hemp. 

The dried flowering tops of Cannabis Indica, native of India, 
and hence the name. It is however ascertained that the common 
hemp of this country, Cannabis Sativa, is identical in its main 
features with the India plant, particularly as regards its medici- 
nal properties. 

Various and contradictory reports of the physiological action 
of hemp have been made. In Asia, results differing widely 
from those following its administration in England and this 
country have been reported. Delirium, intoxication and cata- 
lepsy were the almost constant effects of full doses of the remedy 
in India, while they are rarely discovered here. Difference in 
the temperament of the races, and inequality in the strength of 
the preparation in the two countries, have been mentioned in 
explanation. There is no doubt that the preparations of hemp, 
20 



306 



ACOLOGY 




Cannabis sativa 



Like those of many other plants, arc of uncertain strength, owing, 
first, to the imperfect manner in which the collection or preserva- 
tion is conducted; secondly, to the im- 
proper mode of preparation ; and thirdly, 
to deterioration from exposure or other- 
wise, after being put up for use. 

Notwithstanding the discrepancy in the 
reports of experimenters, the fact that 
cannabis possesses the property of cerebral 
stimulation, in a high degree, is well es- 
tablished. In gout, rheumatism and neu- 
ralgia its anodyne effect will be exhibited. 
Its action as a stimulant upon the whole 
cerebro-spinal nervous centres has been 
inferred from the relief afforded by it in 
tetanus and hydrophobia; particularly the 
former, in which, from the statistical re- 
ports of authors, its curative effects seem 
probable. In order to a proper test of its virtues, the remedy 
must be given so as to produce visible impression, and continued 
sufficiently long to insure its full influence. 

Powerful remedies, in the use of which the practitioner has 
but little experience, may be unjustly condemned from a want of 
boldness and perseverance in their use. On the other hand, the 
want of judicious caution may lead to still more unfortunate re- 
sults. The established physiological action of cannabis makes 
it, beyond question, a valuable therapeutic agent, and as its 
poisonous effects from large doses have not been found alarming, 
a rational application of it should be made in the treatment of 
tetanus, chorea, mania, delirium tremens, etc., when occasion 
demands. 

Extractum Cannabis — Extract of Indian Hemp. This is the 
only form of preparation in which the remedy is used. It is a 
resinous, alcoholic extract, made by evaporating the tincture to 
a solid consistence. The dose is one grain, repeated every three 
hours, and increased, if necessary, till the full effects are realized. 
When a subject is thoroughly impressed by it, several hours are 



AND THERAPEUTICS. 307 

required for its effects to pass off. By commencing with less 
than the full dose, and regularly increasing the quantity until 
symptoms of the anodyne or exhilarating effects appear, there is 
no risk of excessive action. 

Tinctura Cannabis — Tincture of Hemp. This preparation, 
from which the extract is made, may be used with conveni- 
ence, in the dose oj about thirty drops. It is necessary, however, 
to dilute it with sweetened water, instead of plain, as other resinous 
tinctures, lest the resin, in which the virtues of the remedy reside, 
precipitate and adhere to the vessel from which it is given. 

CLASS II. 

CEREBRAL SEDATIVES. 

Depression of the vital energies occurs from various and seem- 
ingly very different causes. Some of the means which, under 
certain circumstances, lead to complete suspension of some func- 
tions of the brain, seem, under a different state of things, to 
have an exactly opposite effect. Chloroform, for example, when 
taken into the stomach in the dose of a fluidrachm, is absorbed 
slowly, and excites the brain merely to increased activity; but 
when inhaled in the same quantity, disturbance of function and 
a tendency to inactivity of the portion presiding over the intel- 
lectual faculties, is the result. A plausible explanation of these 
results is, that the remedy is rapidly absorbed from the lungs, 
making a powerful but transitory impression upon the brain, 
and that excessive excitation suddenly produced leads to the ar- 
rest of its functions as perfectly as the action of sedatives. This 
is also the result of poisonous doses of other cerebral excitants 
taken into the stomach; the absorption continuing so as to keep 
up this destructive excitement for hours after being swallowed. 

Sedatives lessen the activity of an organ, and thereby modify 
its functions to the same extent. Several varieties of cerebral 
sedatives may be mentioned, each acting upon different portions 
of the nervous centres within the cranium. Some, as above 
stated, act primarily as powerful excitants temporarily, but in- 
duce depression and suspension of function very soon, if taken 



308 ACOLOGY 

in large doeee or absorbed rapidly. So prompt, indeed, is the 
depression, stupor, or anaesthesia, that it could hardly be termed 
the secondary action of the agent. Opium and other cerebral 
stimulants, in ordinary doses, leave as a result, or secondary ac- 
tion, stupor or depression, but only after the exhilaration has 
lasted for a considerable length of time — long enough for the 
remedies to have expended their foree. 

Cerebral sedatives are used for very different purposes. The 
variety which leads to general depression of most of the vital 
functions, and consequently to general relaxation and sedation 
without arresting the intellectual and sensory functions, is given 
with very different object from that had in the use of remedies 
which produce unconciousness without any general functional 
depression throughout the body. We shall, therefore, designate 
them by the terms "prostrating" and "anaesthetic" cerebral se- 
datives. 

Anaesthetic Cerebral Sedatives. 

The means of producing insensibility to pain in surgical and 
obstetrical practice were not used till a comparatively recent date 
in the history of medicine; and the honor of the discovery is 
claimed by American surgeons. Anaesthesia is useful, not only 
to prevent suffering and thereby afford comfort to the patient, 
but as a means of lessening the liability to fatal shocks of the 
nervous system from violent surgical operations. The irritabil- 
ity which leads to high inflammatory action after painful opera- 
tions is, in a great degree, prevented ; and the parturient female 
is spared much suffering, and sometimes danger, by this discov- 
ery. It is rarely indeed the case that uterine contractions are in 
the least suspended by anaesthesia. On the contrary, in irritable 
subjects, with unusual susceptibility to pain, such remedies may 
not only lessen the amount of suffering, but even facilitate the 
progress of labor. More than partial insensibility is rarely, if 
ever, necessary in obstetrics. Unless the labor be very painful 
and of short duration, it is not proper to keep the patient even 
partially under its influence the whole time, and, in many cases, 
anaesthetic agents should not be used at all. 



AND THERAPEUTICS. 309 

Catalogue of Anesthetic Cerebral Sedatives. 

JEther, Nitrous Oxide, 

Chloroformum, Chloral. 

JEther — Ether. 

This liquid has been described in the class of cerebral stimu- 
lants, and is now referred to only in connection with its anaes- 
thetic property. Ether was the first article of the class used to 
produce insensibility during surgical operations, and, on account 
of being less dangerous, is now considered by some surgeons 
superior to any other. Comparatively few reports of fatal results 
from it have been made, and yet, because of its unpleasant odor, 
and the nausea which sometimes follows, it is not in very gen- 
eral use. 

A fluidounce or more is necessary to produce insensibility, and 
may be inhaled from a napkin or sponge — care being taken to 
keep it a sufficient distance from the nose to admit the air also. 

Chloroformum — Chloroform. 

This prominent cerebral stimulant is in general use also as an 
anaesthetic, and is made to induce these opposite conditions by 
the modes of administration. It was discovered by chemists in 
the United States, France and Germany about the same time 
(1831), but the credit of its first application to prevent pain in 
surgical operations is said to have been claimed by Dr. Simpson, 
of Edinburgh, in 1847, one year after ether had been used for 
this purpose in Boston. The pleasantness of its taste and odor, 
the promptness with which it acts, and the quantity required, 
were some of the advantages over ether claimed for it by Dr. 
Simpson, and which have no doubt led to its supplanting the 
latter. On account of these properties, the fatal results attend- 
ing its use have not been sufficient to deter the profession from 
making it the chief anaesthetic. Doubtless the danger to be ap- 
prehended from it is magnified in the minds of those who care- 
fully treasure up the reports of fatal cases, without calling to 



310 ACOLOGY 

mind the fact that hundreds of thousands are taking it safely 
while one dies under its influence. A mixture of ether and 
chloroform is supposed to be less dangerous, and has been pro- 
posed as a substitute for either of them separately. Surgeons 
and obstetricians, however, who have used chloroform by inhala- 
tion for twenty years without a serious casualty, are not likely 
to abandon it. Two or three fluidrachms will generally destroy 
sensibility, and may be used as directed for the inhalation of 
ether. 

Nitrous Oxide — Laughing Gas. 

This, in chemical language, is the protoxide of nitrogen, and 
has long been known as capable of producing exhilaration or 
intoxication when inhaled. More recently, its anaesthetic power 
has been sought by dentists, in the extraction of teeth. For 
this, and other painful operations requiring only a few moments 
for their performance, the nitrous oxide makes an appropriate an- 
sesthetic. The difficulty attending its use in extended operations 
is, that the state of insensibility from one inhalation is not suffi- 
ciently long, and volition, which cannot always be commanded 
again in a reasonable time, is necessary to its repetition. Recent 
experiments with it in surgery lead to these conclusions. It 
will, probably, therefore, be used as heretofore, only as a source 
of amusement and for dental purposes. 

Chloral. 

Uncombined or anhydrous chloral is in the form of an oily 
fluid, and is made by the action of chlorine on alcohol. In this 
state it is difficult to preserve its purity for any considerable 
length of time. 

Chloral Hydrate — Hydrate of Chloral — is formed by a combi- 
nation of chloral with water, in which we have the very rare 
occurrence of a solid resulting from the mixture of two fluids. 
Beautiful crystaline masses are thus formed, and, though volatile, 
may be kept safely in glass-stoppered bottles. It is of peculiar 
odor, sweetish taste, and is readily soluble in water. Its decom- 
position by contact with an alkali is said to result in the produc- 



AND THERAPEUTICS. 311 

tion of pure chloroform, and some of its effects are probably 
ascribable to the action of this agent, formed by an alkali met 
with in the blood. 

The ordinary action of chloral upon the brain leads to a tem- 
porary suspension of some of its functions in the production of 
that state of rest called sleep. The rest, though natural, is said 
to be so profound sometimes as to resemble imperfect anaesthesia, 
and affords immunity from suffering in painful conditions, inju- 
ries and slight surgical operations. 

Hydrate of chloral has been found useful in wakefulness from 
general irritability or other cause. Mania a potu affords that 
condition of the brain in which its good effects are readily seen. 
Sleep is promptly induced, and a general sedative and quieting 
influence exerted. 

The physiological action of chloral hydrate, according to the 
reports of practitioners in this country, does not observe that 
uniformity expected from the same preparation of any remedy. 
Chloral with alcohol forms a solid, resembling very much that 
of its union with water, and this alcoholate is supposed to be 
mistaken for the hydrate, in the cases of failure to produce the 
usual effects of the remedy. 

Two German chemists have experimented in making combin- 
ations of it with alcohol and with water. They determine that 
the two preparations differ materially in their medicinal, not- 
withstanding the similarity of sensible properties. These experi- 
menters make known a test by which imposition in the sale of 
an improper preparation may be detected. The pure hydrate of 
chloral boils at 95° C. (203° Fahr.), while the alcoholate re- 
quires a temperature of 115° C. (239° Fahr.) {American Jour- 
nal of Pharmacy, 1870.) 

Chloral, though a local irritant, may be given safely by the 
stomach when properly diluted. In the proportion of ten grains 
to two fluidounces of water, no unpleasant local irritation will 
occur; and in this quantity restlessness and cerebral excitement 
is often allayed, notwithstanding the remedy is frequently re- 
quired in three times this amount. The dose, therefore, is from 
ten to thirty grains, repeated in an hour or two if necessary. 



312 ACOLOGY 

From reports made to the Atlanta Academy of Medicine by 
members who had used chloral as an anodyne and hypnotic in 

various conditions, it would seem that unpleasant and sometimes 
dangerous results are likely to occur when it is given in bron- 
chial and pneumonic diseases. Alarming prostration was wit- 
nessed by two intelligent physicians Prom its use in dilli-rent 
aifections of the respiratory organs. 

Prostrating Cerebral Sedatives. 

Since the promotion of health, strength and vigor is the ulti- 
mate object of therapeutics, it seems somewhat unreasonable to 
induce the opposite condition in order to obtain these results. 
As in the use of cardiac sedatives, this course is however some- 
times pressingly demanded. It is necessary, not only to insure 
the general relaxation and sedation by which inflammatory affec- 
tions are relieved, but to allay irritable and excited states of the 
brain itself. Our arrangement of remedial agents is founded ex- 
clusively on physiological action, and no article will be found in 
this or any other class, which is not supposed to act directly upon 
the organ indicated by the name of such class. Indirect de- 
pressing influence is exerted upon the cranial nervous centres, 
by nausea, depletion, etc. Such, however, do not properly be- 
long to the class now under consideration. 

Catalogue of Prostrating Cerebral Sedatives. 

Tabacum, 

Acidum Hydrocyanicum, 

Tabacum — Tobacco. 

The leaves of Nicotiana Tabacum, an annual herbaceous plant, 
native of Central America, but cultivated in several States of the 
Union as a commercial commodity. For the gratification of the 
artificial taste contracted by habitual use, tobacco undergoes 
various forms of preparation to suit each particular mode of 
using it. From any of these the usual pharmaceutical prepara- 
tions can be made. 



AtiD THERAPEUTICS. 313 

The physiological effects of tobacco are nausea and cerebral 
depression. As already stated, the former, whether produced by 
tobacco or other inverse peristaltic excitant, leads to more or less 
nervous depression, but this drug, although a nauseant, and to 
this extent an indirect cerebral sedative, has also a direct de- 
pressing influence, which is generally termed its narcotic action. 
This term perhaps is not inappropriately applied to this effect 
of tobacco, for the inactivity and stupor is one of the primary 
and direct actions of the article. Though seldom, it sometimes 
becomes necessary to depress the vital energies to the lowest pos- 
sible extent consistent with safety. To do this, it is necessary 
that direct sedative or narcotic action upon the brain be resorted 
to. In strangulated hernia, the passage of renal and biliary 
calculi, and in certain forms of tonic spasm of muscular struc- 
tures, it sometimes becomes necessary to allay the excessive and 
even ordinary rigidity of the part. The arrest of vitality or 
nerve force by the direct and indirect sedative action of tobacco 
induces the most perfect relaxation, and may be used with advan- 
tage under such circumstances. 

Infusum Tabacum — Infusion of Tobacco. This is the usual 
preparation for medicinal purposes, and answers well for admin- 
istration by the mouth or rectum. The latter mode is preferable 
on some accounts, and equally effectual in making the desired 
impression. The dose, when taken into the stomach, is one or 
two fluidounces, and about three times this amount, when taken by 
injection, to be repeated in an hour, if necessary. 

Acidum Hydrocyanicum Dilutum— Diluted HydrocyanicAcid. 

Prussic acid is a deadly poison, destroying life more speedily 
than most other destructive agents. The physiological actions of 
the remedy are exerted upon the heart as a tonic, and upon the brain 
as a sedative. This impression upon the nervous centre, when 
in moderate degree, may be made to subserve valuable therapeutic 
purposes, but caution is required in its use, to prevent excessive 
or poisonous action. It has been found useful in the irritable, 
spasmodic cough of asthma, and that attending phthisis, by 



314 ACOLOGY 

which the patient is agitated, and disturbed from sleep during 
the night In delirium, mania, and general convulsive and 

spasmodic disease, dependent upon excitement of the greal ner- 
vous centre, its application would seem more rational. The 
dose 18 three orfour drops, given in syrup or gum water. 

Potmsii Oyanidum — Oyanide of Potassium. This, when pure, 
is in white opake masses. It is soluble in water, and slightly 
deliquesces in moist atmosphere. The salt acts as a poison and 
medicinal agent in every respect similarly to hydrocyanic acid. 
It is, however, preferable as a medicine on account of its uniform 
strength and less liability to decomposition. The dose is one- 
eighth of a grain, dissolved in a little water. 

CLASS III. 

CEREBRAL TONICS. 

In pursuance of the plan of this work, it becomes necessary 
to collect in this class all the remedies whose known physiologi- 
cal action affords tone or permanent energy to the brain. To do 
this requires innovation upon the popular classifications of au- 
thors; regrets for the existing necessity for which have already 
been expressed. 

In making these material changes in classification, we do not 
wish to be understood as intimating that they are founded upon 
new properties discovered by the author. On the contrary, the 
opinion of authors, to whose classification we object, is, we think, 
in the main correct in regard to the physiological action of rem- 
edies. On this point all pretty nearly agree. The practical 
advantage to the learner, which we seek, is the arrangement of 
all known remedies into classes, the names of which denote the 
part of the body acted on, physiologically, and the kind of action 
exerted — whether stimulating, tonic or sedative. 

The remedies which we shall place under the head of cerebral 
tonics have been variously arranged, as "nervous stimulants," 
" neurotics," " nervous tonics," etc. It has been thought suffi- 
ciently explicit to give them the latter name, since they are 
known to act as tonics upon some portion of the nervous system. 



AND THERAPEUTICS. 315 

The practical error, we think, consists in conveying the idea of 
their applicability to derangement of any portion of this system 
requiring tonic action. This would lead to as grave error in 
practice as if they were denominated digestive tonics; for, in all 
detailed reports of the successful application of these remedies, 
the brain itself is the acknowledged seat of the affections. Thus, 
the preparations of zinc, copper, etc., have been found useful in 
epilepsy, mania, and other diseases giving evidence of a de- 
ranged condition of that organ. Other neurotics, known to act 
on the spinal centre, have not been found useful in these ailments, 
but in affections dependent on a morbid condition of the spinal 
cord and its nerves. 

The articles of this class are applicable more particularly in 
chronic diseases, and their impression, being made slowly, is 
durable when induced. 

Catalogue of Cerebral Tonics. 

Phosphorus, Argenti Nitras, 

Zinci Sulphas, Centaurea, 

Cuprum, Brominum. 

Phosphorus. 

This is a substance found variously combined with alkaline 
bases, in animal, vegetable, and mineral productions, in the 
forms of phosphates and phosphites, according as phosphoric 
or phosphorous acid enters into the combination. As found in 
commerce, phosphorus is a translucent, solid substance, and has 
such an affinity for oxygen that it is liable to spontaneous com- 
bustion unless kept immersed in water. 

It is a powerful irritant poison, giving rise to intense local 
irritation and inflammation of the alimentary mucous membrane 
when swallowed in substance. It has been considered a power- 
ful general stimulant to the circulatory as well as to the nervous 
system. This general excitement may, in part at least, arise from 
the excessive local irritation above described. At the same time, 
the brain itself may be temporarily excited. 

The most important action, however, of phosphorus is that of 



316 ACOUMJV 

increased permanent vigor communicated to the nervous centres 
by what is supposed the increase of aeurine, or nerve substance. 
This is the explanation of its tonic effect, and there are reasons 
tor admitting its correctness. It is known that phosphorus is 
a constant ingredient in the brain, and is therefore supposed to 
be an essential element in its structure. The fact of its tonic 
effect also being well established, it is natural to suppose that, 
the necessary ingredient being directly afforded, leads to this 
result. 

Phosphorus has been lauded greatly by Dr. Churchill as a 
remedy for constitutional tuberculosis, seemingly under the im- 
pression that it exercised catalytic action upon tuberculous matter. 
With other practitioners, the reputation given it by this author 
has not been sustained, and it is at least doubtful whether any 
such action can be justly attributed to it. It is very well known 
that tuberculous subjects are more certainly protected against 
accumulation and disastrous results of this substance by the in- 
crease and constant support of nervous force. Hence, alcohol, 
opium, bracing air, etc., are universally acknowledged as useful 
for this purpose. Phosphorus, acting not upon the deposit, but 
upon the brain, as a tonic instead of stimulant, gives more perm- 
anent nervous power than these. 

Would that some certain catalytic could be found for this de- 
stroyer of mankind ! Let not experiments in this direction be 
abandoned. He who shall make this discovery will be hailed 
as the great protector of his race, and have his name inscribed 
on the scroll of fame, along with that of Jenner and other ben- 
efactors of mankind ! ! 

Phosphorus may be given in substance in the dose of one- 
twentieth of a grain dissolved in oil or ether. A solution of cod- 
liver oil has been suggested and practiced as a means of intro- 
ducing a celebrated calorific, so renowned in phthisis, along with 
the cerebral tonic, >ov promoter of nerve force. 

Phosphorous acid, in combination with alkaline bases in the 
form of hypophosphites, is now a popular means of introducing 
phosphorus into the system, and in this form has given rise to 
flattering accounts of its use in phthisis. It is supposed, aud 



AND THERAPEUTICS. 317 

doubtless correctly, that the phosphorous acid is set free, before 
or after absorption, and, by its deoxidizing property, is converted 
into phosphoric acid, In this way the salt is made to answer the 
same purpose as phosphorus given in substance, while all the un- 
pleasantness and difficulty of administration is avoided. 

Hijpophosphite of Calcium is of pearly whiteness, is readily 
soluble, and given in the close of ten to twenty grains, three 
times a day, dissolved in water. Combinations of phosphorous 
acid with sodium and potassium, making the hypophosphites of 
these bases, are in use for the same purposes as the preparation 
with calcium. Indeed, all of these are sometimes mixed in the 
same solution, but perhaps without any practical advantage. 
The full effects of the remedy may be obtained from any one 
of them ; and the dose of each is the same, say about fifteen grains 
ordinarily. 

Zinci Sulphas — Sulphate of Zinc. 

This salt resembles somewhat the sulphate of magnesium, 
having transparent prismatic crystals. It is soluble in water, 
has a very unpleasant styptic taste, and effloresces when exposed 
to the atmosphere, falling into a white powder without losing its 
active properties. Alkalies, acetate of lead and vegetable astrin- 
gents are incompatible, and should not be administered with it. 

While this preparation has been considered more particularly 
useful in chronic nervous disturbance, such as epilepsy and other 
forms of permanent convulsive disease, yet there is reason to be- 
lieve that its tonic action is serviceable in acute disease of the 
great nervous centre, such as typhoid and other forms of adynamic 
fever. Its astringent property also makes it useful in this dis- 
ease, when, as is often the case, the attending diarrhoea requires 
such action. 

It is not, however, in general use, in the treatment of typhoid 
fever, either for its astringency or its tonic effect upon the nervous 
centres; but the favorable result of a case, witnessed by the author, 
in which this salt was given for its astringent effect, induced the 
belief that the nervous system was also favorably impressed by 
it. In the convulsions of young subjects, even when there is no 



318 ACOLOGY 

reason to suspect confirmed epilepsy, the salt will be found use- 
ful. At this age convulsions are often the result of irritation in 
the alimentary canal, for which the astringency is useful, while 
its tonic property serves to relieve the nervous susceptibility. 

The dose, as a cerebral tonic, is one or two grains, given in 
watery solution or in the form of pill. 

Cuprum — Copper. 

The preparations of copper have been much praised for their 
good effects in the treatment of epilepsy. 

Cupri Sulphas — Sulphate of Copper. This preparation of 
copper has been noticed under the head of emetics, and its sen- 
sible properties given. While this salt possesses the general 
tonic properties of the metal, yet other preparations have been 
preferred in affections requiring the action of cerebral tonics. 

It may be given in epilepsy, mania, and other forms of chronic 
nervous disease dependent on a want of healthy vigor of the 
brain. The dose is one-fourth of a grain, gradually increased to 
two or more. 

Cuprum Ammoniatum — Ammoniated Copper. This prepara- 
tion is preferred by some, in the treatment of epilepsy, to any of 
the mineral cerebral tonics. Repeated experiments with it prove 
its value for this purpose, and incurable cases of epilepsy are often 
greatly benefited by lengthening the period between paroxysms 
of the disease. 

Ammoniated copper may be given in the dose of one-fourth of 
a grain, in the form of pill, gradually increased to two or three 
grains three times a day. 

Argentt Nitras — Nitrate of Silver. 

This is in the form of flat, transparent crystals, of styptic, 
metallic taste, and soluble in water. Its local action is that of 
cauterant, catheretic or mild astringent, according as it is more 
or less diluted.* Of these properties, the reader will find a more 
extended account under appropriate heads. 

In this place it is proper to notice it only in connection with 



AND THERAPEUTICS. 319 

its internal use as a cerebral tonic, and in the crystaline form 
above described, it should be given for this purpose. It is said 
that, when taken for a long time, it imparts a dark color to the 
skin, but no such effect need be apprehended when used only the 
ordinary length of time required to effect the usual objects of its 
administration. 

No cerebral tonic has been more generally used in the treat- 
ment of epilepsy than the nitrate of silver; but its tonic effect 
upon the great nervous centre has also been sought in diseases 
less permanent in their character. Dr. Mitchell, of Philadel- 
phia, found very satisfactory results from its regular use in the 
treatment of typhoid fever, and others speak favorably of it in 
this disease, but attribute its good effects principally to the cath- 
eretic action of the salt upon the irritable alimentary mucous 
membrane. Although its invigorating effect upon the brain 
may prove beneficial, exclusive reliance on this or other nervous 
tonics to keep up the nervous energies is not, perhaps, justifiable; 
for tonics whose effects are slowly produced will not always meet 
the emergency in this fever. Angina pectoris and chorea are also 
said to be favorably impressed with the neurotic action of this 
remedy. 

In order to preserve the activity of the remedy, it is necessary 
to bear in mind the fact that common salt, an ingredient in most 
kinds of food, is incompatible with it, and should not be used 
to any extent immediately before or after it is taken. A want 
of care in this particular doubtless leads often to complete failure 
in producing the ordinary effects of remedies. If salt food 
should be taken at all during the use of this remedy, the admin- 
istration should be made at a period intermediate between the 
regular meals. The dose is one-fourth of a grain, gradually in- 
creased to two grains or more, three times daily, and solution or 
pill. 

Centaurea — Thistle. 

The leaves of Centaurea Benedicta, or Blessed Thistle, an her- 
baceous annual plant, native of Europe, and cultivated in the 
United States. It grows to the height of one or two feet, with 



320 ACOLOGY 

numerous, rather slender branches, which, at the time of flower* 
in-, fail to maintain the erect position and become tangled on 
the ground, giving somewhat the appearance of a twining plant. 
The leaves, on their edges, have -harp points, making it diffi- 
cult to handle them without pricking the fingers, as with the 
ordinary thistle, which it resembles very much in many respects. 

Fit Weed, as it is vulgarly called, has gained some notoriety 
in Georgia as a remedy for epilepsy. The plant has heretofore 
been considered useful only as a diaphoretic ptysan, but from 
experiments made by Dr. W. F. Westmoreland, in the treat- 
ment of epilepsy during the late war, it bids fair to become a 
popular remedy for this dread malady. The difficulty of ob- 
taining the plant, or seed from which to raise it, since the war, 
interferes with further experiments for the present. 

Decoction is the form of preparation in which it has been used 
in this city, and is made by boiling sixty grains of the dried 
leaves for a few moments in a pint of water. Of this three or 
four fluidounces are taken three times a day. 

A species of thistle, resembling very much the centaurea bene- 
dicta is found abundantly on the commons and in various places 
in the neighborhood of Atlanta. This is known among the 
people of the neighborhood in which it is found as the Canada 
TJ uxtle, and differs from fit weed only in having a stouter stem, 
and maintaining the erect position. A case of epilepsy is now 
under treatment with this plant, in the same form of preparation 
and dose as above named for centaurea, and with flattering pros- 
pects of success. 

Brominum — Bromine. 

This is an elementary substance in the form of a volatile liquid^ 
of dark red color, found in salt waters, and in some respects re- 
sembles iodine and chlorine. In the operation of marine and 
spring salt-works it was discovered. Uncombined, bromine is 
rarely used internally, and hence its physiological action has not 
been very satisfactorily determined by the profession. Its re- 
semblance to iodine, and some experiments made with it, have 
induced writers to class it with alteratives; and yet, while it may 



AND THERAPEUTICS. 321 

have useful catalytic effect upon fibrinous and other deposits, there 
is not sufficient evidence of such action to warrant this classifi- 
cation of the remedy. 

Potassii Bromidum — Bromide of Potassium^-is one of the lead- 
ing preparations of bromine, and has attracted very considerable 
attention as a medicinal agent for the last ten years. It has been 
used almost exclusively for its neurotic effect in giving increase of 
energy to the great controlling nerve centres, and as a stimulant 
is less useful than in cases requiring permanent tonic influence. 
In epilepsy, chorea, and other chronic nervous affections, has the 
remedy been more profitably employed. 

. The usual dose is about ten grains dissolved in water, but in epi- 
lepsy, where the intervals between the paroxysms are short, and 
the convulsions violent, thirty to forty grains, three times a day, 
may be given. 

Ammonii Bromidum — Bromide of Ammonium — though differing 
perhaps very little in its medicinal virtues from the above prep- 
aration, has been preferred by certain practitioners. Doubtless, 
in the main, the same general effects are produced by both, and 
habit, or some fancied peculiarity of action, perhaps leads to the 
preference entertained for this. 

The dose is about ten grains, dissolved in water, and repeated 
three or four times a day. Twenty grains, and even more, may 
be used if a more powerful impression be demanded. 

Lithii Bromidum — Bromide of Lithium. This combination of 
bromine and lithium, though not officinal, is probably superior 
to the compounds of bromine with potassium, ammonium, etc. 
If the efficacy of these preparations depends upon the bromine 
in them, this should certainly be preferred, since it is ascertained 
that about 90 per cent, of it consists of bromine, while in the 
compounds of potassium and ammonium it does not reach 80 
per cent. 

Like other preparations of bromine, this seems to give in- 
creased vigor to the great nervous centre at once, affording ano- 
dyne influence, but, from experiments made with it in epilepsy 
is more valuable as a cerebral tonic. 

In the dose of ten grains, gradually increased to twenty or 
21 



322 ACOLOGY 

more, three times a day, epilepsy lias been entirely arrested; and 
when a cure is not effected, great relief is afforded by the tem- 
porary arrest of convulsions. 

CLASS IV. 

EXCITO-MOTOR STIMULANTS OR SPASMODICS. 

The system of motor nerves, which govern muscular contrac- 
tion, excites the objects of their distribution to inordinate action 
by impressions made upon their nervous centre. Certain agents 
are known to have such direct or physiological action, and hence 
are arranged in the class under consideration. Their application 
is easy. When the nervous force necessary to the motor func- 
tions is deficient, causing partial or complete paralysis, these ex- 
citants would seem to be demanded, and will generally prove 
permanently effectual, provided no structural lesion still exists 
in the centre to be acted on. Unfortunately for the general suc- 
cess of the class, however, this physical incapacity often inter- 
feres. Sometimes, when such organic derangement has ceased, 
there remains functional inactivity, which may be remedied by 
this class of agents. 

Catalogue of Excito-Motor Stimulants. 

Nux Vomica, 
• Arnica, 

Electricity. 

Nux Vomica. 

The seed of Strychnos Nux Vomica, a branching tree, native 
of the East Indies. The fruit, which is the size of an orange, 
contains several seeds embedded in the pulpy substance. The 
virtues of nux vomica depend upon two alkaloid principles, 
called strychnia and brucia, residing in these seeds. The former 
being required in one-tenth the amount of the latter, to produce 
the same effect, is used exclusively. 

Strychnia uniformly excites to increased activity the motor 
system of nerves, and perhaps every therapeutic effect of this rem- 




AND THERAPEUTICS. 323 

eclv which has been witnessed may, with propriety, be attributed 
to this physiological action. Although it has been found useful 
in dyspepsia, and hence called a digestive tonic, this result may 
be justly attributable to its direct action upon the nervous sys- 
tem. In a certain form of indigestion, the prominent difficulty 

consists in a want of peristaltic motion — 

i. i Fig. 31. 

torpor of the alimentary muscular struc- 
ture, and it requires no far-fetched reason- 
ing to show that an increase of motive 
power may accomplish the end desired. 
In accordance with this theory of its ac- 
tion, strychnia has been given and found 
useful in paralysis, and permanently so 
when no organic lesion exists. Also in 
general or local muscular debility, not 

, i • /> i Strychnos mix vomica. 

amounting to complete paralysis ot the 

motor nerves, such as indigestion from torpor of the alimentary 
canal, etc. In over doses strychnia is a deadly poison, and should 
be administered cautiously. 

The dose is one-sixteenth of a grain, gradually increased to 
one-tenth, if the desired effects are not produced by less quan- 
tity. With this precaution, no fears need be entertained of ill- 
consequences from its use. 

A Tincture and Solid Extract of nux vomica are officinal, but 
'the uncertainty of strength, owing to want of uniformity in the 
amount of active ingredients in different specimens of the drug 
from which they are made, renders them less reliable than strych- 
nia. The tincture may be given in the dose of twenty to thirty 
drops; of the extract, one grain is sufficient to commence with. 

Arnica — Leopard's Bane. 

The flowers of Arnica Montana, or Leopard's Bane, a peren- 
nial herbaceous plant, about one foot in height, and native of 
Europe. 

The whole plant may be employed, but the flowers being pre- 
ferable, are generally used. While arnica, like nux vomica, is 



32 1 ACOLOGY 

found useful when increased action of the excito-motor system is 
indicated, it has the additional properties, of local irritant to the 
stomach and general excitant of the brain. In the main, how- 
ever, they arc called for under the same state of circumstances. 
In amaurosis, or any other variety of partial or complete paral- 
ysis, dependent upon functional cause, whether the result of vio- 
lence or other origin, the effect of these remedies may be called for. 
It may be given in substance in the dose of about ten grains; 
and of an infusion, made in the proportion of a troyounce to the 
pint of water, half a fluidounce, every two or three hours. 

Electricity. 

The similarity of electric fluid and nervous force is so striking, 
that attempts have been made to prove them identical; and, 
although all the phenomena and laws connected with their pro- 
duction, transmission and effects do not sustain this proposition, 
yet, the vital force necessary to excite muscular contraction is 
afforded by both. While one of these subtle fluids is brought 
into play by chemical or mechanical means, the other seems to 
be the result of functional operations of a chief nervous centre, 
the brain. 

As a remedial agent, electricity is used to supply the place of 
nervous fluid, when deficient, and differs from the motor stimu- 
lants, already described, in that of furnishing a fluid similar, in 
some essential respects, to the natural fluid produced by the ner- 
vous centre, instead of promoting an increased production of the 
latter. Electricity is, therefore, applicable in the same forms of 
disease for which excito-motor stimulants have been recom- 
mended. The permanence of its effects must, of course, depend 
upon the freedom from organic disturbance which originally 
produced the paralysis. If lesion, compression or other organic 
disturbance of the nerves or nervous centre still exists, the mus- 
cular activity given by the remedy will, of course, be temporary, 
and of no permanent benefit until such local difficulty be removed. 

Electricity and galvanism, although generated by very different 
means, are identical in medicinal and other properties. The 



AND THERAPEUTICS. 325 

former is evolved by friction between non-conducting bodies, 
and certain relations of metals with magnets, while the latter 
results from chemical reaction between acids and metals. 

Electro-magnetism is electricity intensified by polarized or mag- 
netized iron. A current generated by a suitable friction appara- 
tus is passed through a coil of wire, around a bundle of iron 
rods, and makes of them temporary magnets, which, in return, 
add immense force to the electric current. When coils of wire 
are made to pass rapidly, in close proximity to the poles of a 
horse-shoe magnet, a current of electricity may be started equal 
to that produced by friction. Instruments operating on these 
principles are used for remedial purposes. 

Galvano-magnetism requires similar arrangement, except that 
the fluid is produced by the operation of a snugly-arranged, 
portable galvanic battery, attached to the apparatus. In this 
way a current of sufficient force for ordinary use can be obtained 
with a very economical consumption of acids and metals. 

The shock, which seems to be necessary to muscular excitation, 
is the result of frequent short interruptions of the current, made 
by a proper adaptation of the apparatus to this end. To cases 
requiring its use, this electro-magnetism or galvano-magnetism 
should be applied for about five minutes daily, for several days, 
or until its powers of relief are thoroughly tested. The current 
should be made to traverse the feeble part, by placing one pole 
on the surface opposite that portion of the spine supplying the 
affected part with nerves, and the other at a point toward the 
peripheral extremities of these nerves. In this way the current 
can be made to pass along the whole length of the affected 
nerves. 

Recently, electricity has been used for the treatment of surgi- 
cal diseases. Tumors of various kinds are absorbed, it is said, 
after having been subjected to a regular course of electricity. 

Electrolysis is the term applied to this system of treatment, 
and decidedly curative effects are claimed for it by those engaged 
in experiments on such diseases. Cancer of the breast is thus 
treated by Dr. A. D. Rockwell, of New York, and his reports of 
cures are certainly entitled to consideration. Needles are inserted 



32<> acologV 

at opposite points in the tumor, and the current made to pass 
through it. He has improved instruments which he usee for 
this purpose. 

CLASS V. 
EXCITO-MOTOR SEDATIVES OR ANTISPASMODICS. 

This class, as will be seen, does not include all neurotic reme- 
dies which have been called "antispasmodics," and which, under 
certain circumstances, relieve spasm. This condition may exist 
in certain parts of the body from irregular and feeble nervous 
influence, and requires for its relief a cerebral or nervous stimu- 
lant, when dependent upon reflex nervous derangement or origi- 
nal inactivity of the centre. Thus opium, chloroform, etc., by 
affording additional nervous force, overcome such derangement 
arising from inactivity of the brain, and sometimes temporarily 
even when other cause of derangement exists. The class of 
remedies under consideration act, physiologically, as sedatives to 
that portion of the nervous centres which presides over the sys- 
tem of nerves called excito-motor, and are applicable in an ex- 
cited state of the centre of this system. 

Catalogue of Excito-Motor Sedatives. 

Conium, 
Woorari, 
Physostigma. 

Coni UM — Hemlock. 

The leaves of Conium Maculatum, an umbelliferous herbace- 
ous plant, with biennial root, and branching stem, four or five 
feet in height. It is a native of Europe, and cultivated in the 
United States. The drug is dependent for its virtues upon an 
alkaloid principle called conia. 

Hemlock is a virulent poison in over quantity, producing 
death by arresting the functions of the excito-motor centre, gen- 
eral paralysis being a common result of poisonous doses. It has, 
from the earliest history of medicine, been the subject of occa- 



AND THERAPEUTICS. 32? 

sional laudation, and as often abandoned by the profession as 
worthless. The peculiar and powerful sedative effect exerted 
upon the great nervous centre of motion is certainty very rarely, 
if ever, called for in treatment of cancer, phthisis, and other 
diseases in which it has been most frequently used. With its 
known effects upon the nervous force, it is difficult to conceive 
of any benefit that could result from its use in the diseases men- 
tioned, unless from other property it may possess. A more ra- 
tional application of the remedy, it would seem, could be made 
in diseases dependent upon abnormal excitement in that portion 
of the nervous system upon which the remedy exerts its sedative 
influence, such as tetanus, chorea, hydrophobia, etc. 

Extractum Conii — Extract of Conium. This is an officinal pre- 
paration, and one in which the remedy may be readily adminis- 
tered in the form of pill. The dose is two grains three times a 
day, very gradually • increased till evidences of its action are 
observed. 

Tindura Conii — Tindure of Conium. In this form the remedy 
can be safely preserved, and conveniently administered in the 
dose of a half to afluidrachm three times a day. 

WOORARI. . 

A vegetable production of unknown origin, discovered by the 
aborigines of a British province of South America. In appear- 
ance, it resembles vegetable extracts, and has been found, on an- 
alysis, contrary to what was once supposed, to contain no animal 
remains. Its effects are much more prompt and violent when 
introduced into the cellular tissues, than when given by the 
stomach or rectum, though, in larger doses, the poisonous action 
is readily developed by the latter modes of introduction. It is 
a violent poison, paralyzing the excito-motor nervous centre, 
and experiments with it on animals prove its direct antagonism 
to the action of strychnia, a fact in contradiction of the opinion 
once entertained, that it is the product of strychnos. In some 
instances of poisoning from it the heart's action continued some 
minutes after respiration ceased. This symptom, however, is 



1528 ACOLOGY 

not constant, as, in other cases, these vital functions ceased at the 
same time. 

From experiments made, the physiological action of the drug 
is very well established, and some experiments carrying out a 
rational course in its application, have tested its virtues in the 
excessive motor-excitement of tetanus, and with favorable results. 

Much time would be saved, and many lives preserved, should 
therapeutists, in their experimental investigations, always labor 
to ascertain, first, the true physiological action of remedies, and 
also the pathological origin of symptoms present. The exces- 
sively poisonous nature of woorari, and the want of information 
as to the origin, mode of administration and dose, have thus far 
interfered with its general use. There are reasons, however, for 
believing that in it may yet be discovered the means of controll- 
ing the heretofore unmanageable affections, tetanus and hydro- 
phobia, particularly the former. Chorea, and other spasmodic 
diseases from excessive nervous excitation, may also be benefited 
by the action of this remedy, at least temporarily. 

Physostigma — Calabar Bean. 

The seed of Physostigma Venenosum, a perennial, climbing 
plant, with ligneous stem, mounting on contiguous trees. 

This plant is a native of Africa, and was unknown to botanists 
till about the year 1859. The fruit, or seed, which has a shining, 
brittle exterior, is the size of a large horse bean, and of brown- 
ish-gray color, the kernel of which is white, pulverizable, and 
without disagreeable taste or odor. The active principle upon 
which its virtues depend is soluble in alcohol, and imperfectly 
so in water. 

Calabar bean has a powerful sedative influence upon the motor 
nerves, the most prominent symptom of which seems to be 
that of muscular prostration and general lethargy. Its impres- 
sion upon the iris leads to a condition opposite that made by 
belladonna — the pupil contracting to small size under its action. 
This seeming antagonism leads to the supposition that one may 
serve as an antidote for poisoning by the other — which, how- 
ever, is by no means certain, since the two substances exert their 



And therapeutics. 329 

principal action upon different portions of the nervous system ; 
and though the abnormal condition of the pupil may be relieved, 
yet other important disturbance may still exist. 

The rational application of this remedy, as suggested by its 
known physiological action upon the motor nerves, is in the 
treatment of spasmodic affections, such as tetanus, hydrophobia, 
etc.; and for which it will doubtless be found equally effectual 
with any remedy used for the treatment of these hitherto incu- 
rable affections. 

CLASS VI. 

SPINAL OR REFLEX NERVOUS STIMULANTS. 

A peculiar form of nervous disturbance, dependent on local 
organic irritation, sometimes exists, and is called reflex nervous 
derangement. The stomach, bowels, uterus or other organs be- 
ing the subject of chronic inflammation or irritable disease of 
any kind, the impression, irritability or sympathy is often trans- 
mitted, through the nerves which supply the diseased part, to the 
spinal cord and sometimes to the brain. In this way temporary 
disturbance or irritation is set up in the nervous centres, and 
also retransmitted or reflected, through the same nerves or others 
arising from the irritated portion of the cord or brain, to such 
parts as are supplied by these nerves. This reflected derange- 
ment gives rise to various forms of functional disturbance, 
evinced by pain, cramps, palpitation, indigestion, dyspnoea — 
symptoms resembling so nearly organic lesion of the parts, that 
they are sometimes mistaken for permanent structural disease. 
For example, an irritable uterus, in which ulceration or endo-me- 
tritis may exist, transmits not only to the cord of the lumbar 
spine, but to that of the dorsal also, an irritation so perceptible 
that it is exhibited in tenderness to the touch along that portion 
of the vertebral column. Under such circumstances, various 
reflex symptoms appear. Globus hystericus, palpitation, flatu- 
lence, and other evidences of functional gastric disturbance, with 
every conceivable pain and ache, may from time to time torment 
the unfortunate sufferer. These are the results of reflex action, 



330 acologY 

from which spinal nervous stimulants give temporary relief. The 
stomach, bowels, kidneys, etc., of both sexes may be the origin 
of a similar stale of the nervous system, but the female seems to 

be more subject, and the uterus a more prolific source than other 
organs. Often, before evidences of diseased womb have been 
discovered, the reflex symptoms are mistaken for biliary, gastric 

or cardiac disease, and when their nervous character is under- 
stood, remedies of the class under consideration are too often 
relied on for permanent relief. While it is true that such a 
state rarely proves fatal, yet it is perhaps equally so for recovery 
to result from any general treatment, directed to these reflex 
symptoms. Reference is made to the means of permanent cure 
of the radical cause, under the head of cat heretics. 

For the temporary relief of nervous derangement thus in- 
duced, the remedies under consideration, which we denominate 
spinal stimulants, may be successfully used. The relief thus 
afforded can only be temporary, because the local disturbance, if 
not removed, still continues to operate on the spinal cord and 
ganglionic system of nervous centres, so as again to develop these 
symptoms. 

In disturbance existing primarily in the spinal cord, embar- 
rassing its functions, the articles of this class have not been con- 
sidered applicable, but since they restore activity to these cen- 
tres when depressed by indirect or reflex impressions, it is rea- 
sonable to suppose they will be found useful, temporarily, in 
such general nervous derangement as results from the poison of 
malaria and other causes operating on the spinal cord directly. 

Catalogue of Spinal Stimulants. 

Assafcetida, Oleum Succini, 

Moschus, Castoreum, 

Cerium, Caffea. 

Assafcetida. 

A concrete exudation from incisions made into the living root 
of Narthex Assafcetida, an herbaceous plant with perennial root, 
native of Persia. It is a gum resin, found in brownish masses, 



AND THERAPEUTICS. 



33i 



made up of portions exhibiting different degrees of consistence 
and shades of color, the odor and taste of which is, to most per- 
sons, decidedly unpleasant. The volatile oil and resin, which 
constitute its active principles, are soluble in alcohol. 

Fig. 32. 




Extraction of Assafoetida. 

Assafoetida has long been considered an antispasmodic, and 
may, with equal propriety, be called an anodyne or carminative. 
We have already mentioned the fact that reflex nervous derange- 
ment may be manifested in abnormal muscular contraction, pain, 
etc., and it is in such cases that the remedy, through its stimu- 
lating influence in relieving this state of the nervous system, be- 
comes, therapeutically, an antispasmodic and anodyne. It is a 



332 ACoLOdi 

popular remedy iii that form of reflex nervous derangement con- 
stituting hysterical paroxysms, which, as the name implies, orig- 
inate in uterine irritation. So universal is its use iu this way, 
that the odor of assafoetida at once suggests the idea of hysteria. 

It is equally applicable in a similar state of the nervous sys- 
tem, originating in local disease elsewhere, and perhaps in 
radical disturbance of the spinal cord. The stomach and bow- 
els are subject to irritation of various kinds, which are transmit- 
ted to, and reflected from, the nervous centre upon the canal itself, 
leading to spasmodic contractions at various points, with collec- 
tion of gas, producing painful tension of the part. Under such 
circumstances, the spinal stimulant will be found to relax the 
spasm and promote flatulent eructations and dejections. Palpi- 
tation and dyspnoea not unfrequently result in this way from 
gastric irritation, and may be temporarily counteracted by this 
remedy. 

The unpleasant odor tends greatly to curtail its use, and other 
articles not more reliable have, in a measure, superseded it. As- 
safoetida may be given in substance in the form of pill or emul- 
sion, in the dose of jive grains, and repeated as becomes necessary. 

Tinctura Assafvetidm — Tincture of Assafoetida — contains all the 
activity of the drug, and affords a convenient form for adminis- 
tration alone, or in connection with other fluid preparations. 

The dose is one fluid radii a, diluted with sweetened water, as 
the presence of plain water relieves the resin from its alcoholic 
solution, and allows its precipitation and adherence to the vessel. 

Oleum Suocini — Oil of Amber. 

The volatile oil of Succinum, or Amber, a resinous substance 
found in alluvial deposits on the sea coast in various parts of the 
world, and is probably the fossil remains of some extinct race 
of animals. The oil is obtained by destructive distillation from 
amber, and is of yellowish color, strong, unpleasant odor, and 
acrid, disagreeable taste. 

The oil of amber possesses the properties of the class to an 
extent sufficient to make it a useful reflex nervous stimulant, 
and has, to some extent, supplanted assafoetida. It is used in 



AND THERArEUTICS. 333 

hysteria, hiccough, palpitation, etc., with benefit. In a case of 
troublesome and persistent hiccough, existing on account of a 
sympathetic or reflex nervous derangement the result of colo- 
rectitis, for which the author was called on to prescribe a few 
years since, the most decided and prompt relief was afforded by 
this oil. 

Not being soluble in water, the usual mode of administration 
is that of temporary mixture or suspension, by first rubbing the 
oil with sugar or gum, and then stirring briskly in water. The 
dose is fifteen drops, repeated as may be necessary. 

Moschus — Musk. 

A concrete secretion from the follicles on the prepuce of 
Moschus Moschiferus, or Mush Deer, an inhabitant of Asia. 
From the scarcity and consequent high price of musk, it is so 
frequently subjected to adulteration that uniformity of action 
from it is scarcely to be expected. 

Musk is of a dark brown color, having a granular appear- 
ance, strong, peculiar odor, and bitter, somewhat acrid taste. It 
is a valuable spinal reflex nervous stimulant, and if found al- 
ways pure, so as to warrant more certainty of action, its use 
would be much more extensive. For the purposes mentioned, 
in connection with the application of assafoetida and oil of am- 
ber, musk will be found an effective stimulant. 

The dose, in substance, is about ten grains, given in the form 
of pill or emulsion, and repeated according to circumstances. 

Castoreum — Castor. 

The concrete secretion of follicles on the prepuce of Castor 
Fiber, or beaver. 

Castor is of light color, streaked with red, strong, peculiar 
odor, and bitter taste. It possesses properties somewhat similar 
to those of musk, and may be used for the same purposes. 

None of these articles are very extensively used in medicine 
for the permanent cure of disease, as they afford only temporary 
relief from nervous derangement. 



334 ACOLOGY 

In sabstance, cantor is given in the dose of ten to fifteen grams. 
Tmctura Oastorei — Tinctwre of Castor — is an officinal prepara- 
tion, and may be given in the dose of one fluidrachm. 

Cerium. 

The use of this metal as a medieine has been so recent and 
limited that its preparations have been recognized only by the 
last revision of the United States Pharmacopoeia. There are, 
however, such well attested facts touching its value as a medi- 
cinal agent, that it has been used as a spinal or nervous stimu- 
lant before such recognition. 

Oerii Oxalas — Oxalate of Cerium. This is a tasteless, inodor- 
ous white salt, of granular appearance and only partially soluble 
in water. It has attracted attention as a nervous stimulant, in 
a form of functional derangement which seems to be the result 
of reflex impression. The vomiting of pregnancy, that most 
unmanageable variety of sympathetic or reflex disturbance, has 
been treated successfully with it. In chorea, its use has proved 
satisfactory, and, although this affection has been supposed to 
arise from radical disease of the nervous centres, and that the 
means of cure must act as cerebral or spinal tonics, yet it is not 
unlikely that a point of irritation exists in the stomach or else- 
where, and is reflected from the centres upon the muscular sys- 
tem. Until its usefulness in the treatment of diseases known to 
depend upon actual disturbance of the brain or cord has been 
made to appear, there is no certainty of its tonic action. The 
dose k one grain three times a day, more conveniently used in 
the form of pill. 

Caffea — Coffee. 

The seed of Caffea Arabica, a small evergreen tree, fifteen to 
twenty feet in height, native of Arabia and Africa, and culti- 
vated in various parts of the world, where the climate is suffi- 
ciently warm and of uniform temperature. 

The fruit, which is harvested twice a year, consists of a berry 
the size of a cherry, containing two small seeds, which, when 
deprived of their coverings, constitue coffee. 



AND THERArEUTICS. 



335 



Although used as an article of diet almost universally through- 
out the civilized world, coffee possesses important medicinal prop- 
erties. Much difference of opinion exists in the medical world as to 
its prime physiological action, and the therapeutic results to be ex- 
pected from it. That it gives very decided increase of nervous 

Fig. 33. 




Caffea Arabica. 

excitement, none will deny; but upon what particular portion of 
the nervous system its action is mainly exerted directly, admits of 
some doubt. If this question is to be determined by the various 
reports of its effects in the treatment of nervous derangement, 
the conclusion is inevitable that the brain, spinal cord and general 



336 ACOLOGY 

nervous system are all excited by it. Vivacity and disinclination 
to sleep, being constant results of its action, lead to the conclusion 

that the brain receives direct impression; and experimenters are 
equally confident of giving increase of energy to the spinal cord 
and of counteracting reflex functional disturbance in the form of 
hysteria, by the use of coffee. 

In addition to the nervous impression, there are good rea- 
for believing that direct loeal influence is exerted also upon the 
stomach, so as to facilitate digestion, by a cup of coffee taken 
immediately after a meal. 

In view of all these facts, the proper place for coffee in a phy- 
siological classification is not readily determined; and in deciding 
to place it in the class under consideration, its direct action also 
upon the brain is acknowledged. Its seeming antagonism to 
opium, in having antidotal effect in poisoning by this drug, does 
not afford a reason to doubt its cerebral stimulation; for, although 
opium in therapeutic doses is an active stimulant to the brain, 
yet, in poisonous quantity, it proves dangerously sedative, and 
requires a stimulant of the organ in order to support the vital 
energies. 

Coffee may be used profitably in nervous headache, hysteria 
and to promote digestion temporarily. It is also valued highly 
as an antidote for the poisonous effects of opium, and the un- 
parched pulverized seeds have been reported as successfully used 
in the treatment of intermittent fever. 

Caffein, the principal active ingredient, of coffee may be used 
uncombined, or in the form of Citrate of Caffein, for the purposes 
above mentioned, in the dose of one or two grains, repeated in an 
hour, if necessary. 

CLASS VII. 

SPINAL SEDATIVES. 

Sedative neurotics, which act on a portion of the cerebro- 
spinal nervous centre below the encephalon, are rarely met with. 
Cerebral sedatives have long been known, but until a compara- 
tively late date no article was found to act as a sedative directly 



AND THERAPEUTICS. 337 

upon the spinal cord. It may be said that cerebral sedatives, 
acting as they do upon the great, governing nervous centre, im- 
press the spinal system as perfectly as would be possible to do by 
agents acting directly upon the cord. Sufficient evidence, how- 
ever, to disprove this position is obtained in the investigation al- 
ready had in the use of cerebral and spinal tonics, and also of 
cerebral and spinal stimulants. 

Spinal sedatives give indirectly more or less impression to the 
organs supplied with nerves from the cord. At the same time 
it would seem that certain functions are promoted by such ac- 
tion. For example, particular emunctories or exhaling surfaces, 
through which the more watery portions of the blood escape, 
such as the bowels, skin and lungs, may transmit fluid much 
more freely ; but it must be remembered that these are passive, 
not active, functions, and the result of depression. The kidneys 
also sometimes allow, under such depressing influence, a kind of 
passive discharge of watery urine. 

The state of the general system thus induced is favorable to 
the relief of inflammatory and febrile diseases, and for these pur- 
poses spinal sedatives are used. 

Catalogue of Spinal Sedatives. 

Gelsemium. 

Gelsemium — Yellow Jasmine. 

The root of Gelsemium Sempervire7is, a perenial climbing plant, 
growing wild and cultivated as an ornament in most southern 
portions of the United States. It rises to considerable height, 
attaching itself to trees and other objects, and has numerous 
beautiful yellow flowers, which in part give rise to the name, 
and for which it is greatly admired. The root is bitter and un- 
pleasant to the taste, and yields its virtues to alcohol and water. 

Yellow Jasmine, as it is familiarly known, is a powerful rem- 
edy, and may produce death in excessive quantity. Its physi- 
ological action is that of a sedative, having depressing influence on 
the spinal cord, prostrating the nervous energies and the body 
generally, without stupor or other evidences of cerebral disturb- 
22 



338 ACOLOGY 

ance. Like thai of some other valuable remedies, the virtue of 
gelsemium was discovered by accident. In the management of 
malarial fever, its control over excitement was ascertained, and 
though not likely to supersede other remedies for the disease, 
this fact led to its successful use in nervous agitation and inflam- 
matory affections. While it may not have any directly sedative 
effect upon the heart, the control over the circulation through 
the nervous system answers a similar purpose. 

A Tincture, made with a troy ounce of the root to a pint of di- 
luted alcohol, may be given in the dose of twenty di^ops, and re- 
peated pro re nata. 

CLASS VIII. 

SPINAL TONICS. 

The action of this class is somewhat peculiar. Most tonics 
require to be given several days, and some of them even weeks, 
before the tonic effect is exhibited in the organ upon which they 
act. This is not the case with spinal tonics in some of the dis- 
eases for which they are given. In one, at least, of the affections 
for which they are celebrated, the curative effect is experienced 
the first day of their administration. Malarial fever, for in- 
stance, is cured sometimes in twelve hours with quinine, and yet 
it is not such relief as stimulants afford, being decidedly more 
permanent. This anomalous action of remedies, which excite 
the nervous system with the promptness of a stimulant and the 
permanence of a tonic, might be supposed to remove some mor- 
bific agent in the blood by catalytic action, but for the fact that 
neuralgia, and other diseases, not dependent upon the same cause, 
are also relieved by them. Indeed, reflex impressions may be, to 
some extent, allayed, not so speedily, yet more permanently by 
them than spinal stimulants. It is also a remarkable fact 
that fevers, dependent upon impressions made by morbific 
cause upon the cranial nervous centres, are not subject to the con- 
trol of spinal tonics. Typhoid fever is one of these, and though 
often subjected to the treatment of such means, is now consid- 
ered beyond their influence. Fevers dependent on primary dis- 



AND THERAPEUTICS. 339 

tnrbance of the spinal centre, and other acute diseases in which 
tonics are useful, generally observe periodical paroxysms, while 
those seated within the cranium are usually, though not always, 
of continued character. 

Catalogue of Spinal Tonics. 

Cinchona, Impluvium, 

Salix, Cimicifuga. 

Corn us, 

Cinchona — Peruvian Bark. 

The bark of Cinchona Calisaya, and other species of cinchona, 
stately trees of South America. There are three principal com- 
mercial .varieties of the bark — the yellow, or calisaya; the pale 
and the red cinchona. These differ in no essential particular, 
having about the same alkaloid active principles, except that 
calisaya is said to contain a larger proportion of quinia, and is, 
therefore, more valuable. Peruvian bark is the most active and 
prompt of the spinal tonics yet discovered. Indeed, its action is 
so speedily produced that, but for the permanence of its effects, 
it would not come within the definition of tonic. As a general 
rule, it is useful in fevers and painful affections of a periodical 
and permanent character. These, as above stated, generally de- 
pend on primary derangement of the spinal nervous centre, or 
of the nerves themselves. Malarial fevers, rheumatism, certain 
forms of neuralgia, and such as result from reflex impressions, 
have such pathological origin, and are, therefore, subject to the 
influence of this remedy. 

Cinchona contains two principal alkaloids upon which its vir- 
tues depend, quinia and einchonia. Of these, the former is con- 
sidered the most important, and has almost entirely superseded 
the preparations of bark in substance, and even the other alka- 
loid principles also. 

Decoction, Infusion and Tincture of the bark are liquid prepa- 
rations, which may be used in the dose of two fluidounces of the 
decoction and infusion, and hoo fluidracfyms of the tincture, every 
two or three hours, until three or more potions have been taken. 



340 




Cinchona Calisaya, var. vera. 
a. Fruit-bearing branch, b. Flowers (natural size.) c. Coroila laid open {magnified.) 
d. Capsule {magnified.) e. Seed {magnified ) 
f. Leaf of var. Josephiana, from a specimen gathered in the province of Bungas, Bolivia. 



AND THERAPEUTICS. 341 

An Extract of bark is officinal, and may be conveniently used 
in the form of pills, in the dose of twenty grains. 

Quintal Sulphas — Sulphate oj Quinia — Quinine. This prepa- 
ration of the chief alkaloid principle of cinchona, is now almost 
universally relied on for the tonic effects of the drug upon the 
spinal cord. It is a light crystaline white salt, of bitter taste, 
and only partially soluble in water. By the addition of a small 
quantity of sulphuric acid, it is completely dissolved in eleven 
times its weight of water. In solution, quinine is doubtless more 
prompt and efficient than the salt in substance, on account of its 
more ready absorption, a portion of which is liable to remain 
undissolved for some time in the primse vise. This difficulty is 
greatly increased by the form of pills, particularly when suffi- 
ciently old to become dry and hard. 

A characteristic symptom produced by quinine, and one by 
which evidence is afforded of its thorough impression, is that of 
ringing in the ears. This sensation is, with some subjects, very 
painful, particularly when a large quantity has been taken. The 
amount necessary to be given at one time, and the proper inter- 
val to be observed between the doses, must be determined by the 
nature of the case, and stage of the disease when treatment is 
commenced. In malignant intermittent fever, when serious con- 
sequences are feared from an approaching paroxysm, thirty, forty, 
and even sixty grains, may be given before the hour it is ex- 
pected. If the time is short, however, say only three or four 
hours are allowed to quininize the patient before the cold stage 
will probably come on, thirty grains should be administered at 
once, and in solution, so that the effect may be realized at the 
earliest possible moment. When, from the history of a case, it 
is satisfactorily determined that a period of ten or twelve hours 
will be allowed, the amount necessary to prevent the chill should 
be divided into two or three portions, and one given every two, 
three or four hours. As a general rule, in all grades of inter- 
mittent and remittent fevers, quinine should be commenced on 
the decline of fever, so as to make sure of the full impression 
before the next exacerbation. The latter will generally present 
the least degree of fever from one to six o'clock in the morning, 



342 ACOLOGY 

and [f twenty "grains be given from twelve to three, fche rise may 
be prevented. The plan of delaying until toward the time (bra 
paroxysm to appear, in order to have the full effect at that junc- 
ture, is hazardous in dangerous cases, and proses ineffectual in 
milder forms. In tertian intermittent, it is sufficient to impress 
the nervous system thoroughly with the remedy on the "well 
day." These general rules are also applicable to the treatment 
of periodica] neuralgia, but in those eases irregularly paroxysmal, 
and in rheumatism, a disease in which quinine is the most efleet- 
ive remedy, it may be given at convenient periods until the full 
effects are realized. Twenty grains, divided as above and given 
on the decline of pain, are sufficient to impress the system in 
ordinary cases. 

The use of opiate preparations in connection with quinine 
should depend upon circumstances connected with the particular 
case under treatment. If the bowels incline to move freely, 
some opiate preparation should be given with the quinine. 
Much of the good effect of this tonic is lost by purging during 
its operation. Opium may also precede it, if pain, nervous 
depression, or other symptoms indicating its use, be present. 
Greater security may be obtained against a threatened paroxysm 
of intermittent fever by an opiate given so as to impress the ner- 
vous system at the time of its onset. Statistical reports, said to 
have been carefully made in a London hospital, seem to justify 
the impression that these remedies are antagonistic in their ac- 
tion. This, however, is not verified in general practice. Acute 
articular rheumatism is probably more certainly cured by using 
some preparation of opium with each portion of quinine; and 
these, with blisters to the spine, have been my reliance in its 
treatment for many years. 

Cinchonicjc Sulphas — Sulphate of Oinchonia. This is a crystal- 
ine salt, of very bitter taste, and sparingly soluble in water, but 
rendered completely so in half its weight, by the addition of a 
small quantity of diluted sulphuric acid — elixir of vitriol. The 
preparation is said to produce the same effects as sulphate of 
quinia, but requires somewhat larger quantity. Its use is very 
limited, compared with that of quinia, but may with propriety 



AND THERAPEUTICS. 343 

be sriven in the treatment of all diseases for which this article is 
so generally prescribed. The quantity necessary to be given be- 
tween the paroxysms of fever is about thirty grains, and may 
be divided into portions for administration at intervals of a few 
hours, as recommended for quinia. 

Salix — Willow, 

The bark of Salix Alba, or White Willow, a small tree, grow- 
ing on low, moist situations in most parts of the United States. 
The bark is bitter, though not very unpleasant to the taste, and 
possesses properties somewhat similar to cinchona. The flatter- 
ing accounts of its use as a substitute for this bark, given by 
certain practitioners, are not confirmed by others equally zealous 
in their investigations on this subject. Willow bark may be 
given in substance and decoction in the same quantities as named 
for cinchona. 

Salicin is supposed to constitute the active ingredient of salix, 
and has been suggested as a substitute for quinine. Though 
doubtless useful in malarial fevers and other paroxysmal diseases, 
in which quinine is relied on, it evidently is greatly inferior to 
this celebrated nervous tonic. The amount of salicin to be used 
between the paroxysms of intermittent fever is forty grains. 

Corxtjs — Dogwood. 

The bark of Cornus Florida, zl small tree, growing abundantly 
throughout this country. The branches, root and trunk afford 
bark having the active properties, but that from the root is said 
to be preferable. The taste is bitter and unpleasant. 

Cornine is the name suggested for a crystalizable substance 
thought to constitute the active principle of the bark, but chem- 
ists have failed to obtain it in a solid form. 

Dogwood is supposed to have properties similar to cinchona, 
and has been used successfully in the treatment of intermittent 
fever, but its use will probably not become general while quinine 
can be obtained. As an ingredient in tonic bitters, for feebleness 
from chronic chills, it is said to be useful. It may be given alone, 
in the form of decoction, in the dose of two or three fluidounces. 



344 ACOLOGY 

impluvium — Shower Bath. 

Water, as a remedial agent, produces different, and sometimes 
exactly opposite effects, by a change of temperature and mode of 

application. It has already been referred to as a refrigerant 

arterial, or cardiac sedative. To produce this effect it must be 
cold, and "fresh portions applied constantly. It serves also as a 
diluent when taken freely as a drink, and as an emolient, relax- 
ing agent, when applied locally by cloths dipped in it when 
warm. These effects are noticed under proper heads in other 
parts of this work. As a spinal nervous tonic, , svater serves an 
important purpose, and requires to be applied in a particular 
manner to effect this object. The general rules for its use as a 
tonic are, that it must be cool, must be suddenly applied but a 
moment to the nude body, and the patient quickly dried and 
dressed. The application should be made early in the morning, 
and followed by exercise in the open air, if the patient's strength 
will permit. 

For the first application, the quantity of water and its tem- 
perature must depend upon the strength and susceptibility of the 
subject. The bath should not be used in a manner to produce 
chilliness and depression afterwards, else the opposite effect from 
that desired will be produced ; therefore, until the patient becomes 
somewhat accustomed to it, the water should be used in small 
quantity and, if necessary, the temperature may be slightly raised. 
A tin or wooden vessel, with perforated bottom, and sufficiently 
large to sprinkle the whole body, will answer in the absence of 
regular arrangement for the purpose. 

The shower bath, when properly applied, is an effective ner- 
vous tonic in debility from reflex local irritation, or inactivity of 
the nervous centres from other cause. Though strictly a tonic, 
the effect of shower bath is not permanent, of course, when the 
prime cause of nervous debility still exists, and requires that 
radical treatment be had in connection with it under such cir- 
cumstances, in order to prove permanently curative. Paralysis, 
languor, general nervous inactivity, and hysterical symptoms, are 
greatly relieved by this means. 



AND THERAPEUTICS. 
Cimicifuga — Black Snaheroot. 



345 



The root of Cimicifuga Racemosa, an indigenous herbaceous 
plant, six or eight feet high, with perennial root, and found in 
most parts of the United States, growing in shady situations. 

' Fig. 85. 




346 acologV 

Cohosh, as it is sometimes called, yields its virtues to water* 
and alcohol. A resinous substance is precipitated (ruin the tinc- 
ture by adding water, which has been by the Eclectics improp- 
erly called ('(iiiicij'u(/iii, and used in the dose of one or tiro grains, 

Cimicifuga, from numerous experiments made with it, is con- 
sidered useful in rheumatism, chorea, and other conditions de- 
pendent upon a deranged state of the spinal nervous centres. Its 
action seems to be that of a tonic, and hence it is arranged in the 
class of spinal tonics, notwithstanding the promptness of its ef- 
fects has led practitioners to recognize it as a stimulant. 

Extractum Cimieiftigte Fluidv/m — Fluid Extract of Cimicifuga — 
is an officinal preparation, and may be conveniently used when 
the remedy is required. The dose is half a jiuidrachm to onefluid- 
rachm three times a day, or more frequently if desirable. 

The Tincture is kept in the shops, and may be used in the dose 
of one jiuidrachm, repeated every four to six hours. 

The preparations of this remedy are supposed to give increase 
of power to the nerves of organic life, and vasso-motor nerves 
especially, and therefore tend to promote nutrition and capillary 
circulation. {Medical and Surgical Reporter.) 



DIVISION V. 

REMEDIES THAT AFFECT THE SECERNENT SYSTEM. 

The system of glands which are affected by this division of 
remedies is not extensive, yet important in the animal economy. 
Another system of glands (lymphatic), which differ materially 
in their function from those under consideration, is profusely 
distributed throughout the body. These do not belong to the 
secernent or secreting system, but seem to serve as a kind of 
sieve to rectify certain fluids which pass through them. A third 
variety consists of imperfect glandular bodies called follicles, 
which are abundantly distributed beneath the mucous membranes, 
upon whose surface their secretion is poured out. These rudi- 



AND THERAPEUTICS. 34? 

mental glands secrete the mucus which lubricates the lining 
membrane of all open cavities, and are more or less influenced 
by direct impressions made upon the mucous membranes; but, 
so far as is known, have no elective action exerted upon them- 
selves. 

Thus it will be seen that the secernent system, to which 
this division of remedies applies, is limited to the salivary 
glands, the liver, kidneys and testicles. The lachrymal and 
mammary glands are not included, for the reason that the pro- 
fession is in possession of no well-established facts going to show 
any elective action exerted upon them by remedies. Mechanical 
irritation, the stimulus of cool air, and bright objects, as well as 
mental influences, increase the quantity of tears. The secretion 
of milk by the female mammae is also subject to modification 
by natural causes, and remedies have been proposed with a 
view to their physiological action in this way, but the result of 
their use is by no means satisfactory. The pancreas may be the 
subject of influences supposed to be exerted upon other of the 
chylopoietic viscera, but of such nothing is known definitely. 

CLASS I. 

HEPATICO-SALIVARY STIMULANTS. 

The union of hepatic and salivary stimulants is made a prac- 
tical necessity, from the known fact that the most purely elective 
agents having this physiological action upon the liver, excite also 
the salivary glands to increased secretion. It is true that an 
increased flow of bile into the bowels, by means not directly 
affecting either of these systems, is caused by evacuating the 
duodenum of the impacted contents with cathartics, and this is 
erroneously attributed to an exciting influence of the remedy 
upon the liver. Under such circumstances the bile, though se- 
creted in sufficient quantity, is prevented ingress to the bowels 
by the accumulated contents, and engorges the receptacle and 
ducts, causing painful distention of these parts. Emetics and 
cathartics, when this state of the organ exists, merely give evi- 
dence of the abundance of bile, instead of promoting its secre- 



348 ACOWXJtt 

tion, further than the mechanical relief given to the functional 
disturbance <>(' fche liver from obstruction to the escape of its se- 
cretion. The absorption of l>ile is not uncommon in this condi- 
tion, and an icterus line of the albuginia and skin is the result. 

Hence, m malarial autumnal fevers, when torpor of the bowels, 
from depressed nervous energies, <>r duodenal irritation interferes 

with the flow of bile, the above symptoms being prominent, the 
patient is said to be "bilious," and the disease is called "bilious 
fever." Obstruction to the passage of bile into the bowel occurs 
sometimes simply from congestion or inflammation of the duo- 
denum, and produces a train of symptoms known as "jaundice;" 
and for its relief hepatic excitants are given by those who believe 
the difficulty arises in failure of the liver to secrete bile, and its 
consequent retention in the blood. These pathologists forget, 
however, that bile does not exist till secreted in the liver, by the 
peculiar function of that organ, and would find much more 
speedy relief to their patient by counteracting the duodenal irri- 
tation and congestion by counter irritation, etc. 

The effect of this class upon the salivary glands is not gener- 
ally, if ever, desirable in the treatment of disease, yet a knowl- 
edge of this impression is necessary to the proper and safe use of 
the remedies. When an article is administered with the view of 
deriving benefit from its cholagogue effect, the fact that it may 
excite also the salivary glands, and, under certain circumstances, 
even to inflammatory action, should certainly be known. To 
salivation from mercury has been attributed the cure of the con- 
stitutional effects of syphilis, upon the theory that the remedy 
sets up a disease in the glands also, and that two diseases cannot 
exist in a person at the same time. It has been ascertained, 
however, that the cure is effected by the remedy just as readily 
without salivation, and that, in all probability, the action is 
wholly catalytic. Indeed, some of the best practitioners in the 
treatment of venerial diseases declare that salivation will not 
readily, if at all, occur until the syphilitic virus is eradicated. 

The cure of malarial fever has also been ascribed to the coun- 
ter-irritating, depleting or revulsive effect of mercurial saliva- 
tion, and, in proof of the theory, instances are given in which no 



AND THERAPEUTICS. 349 

excessive exacerbation of fever occurred after salivation is ef- 
fected. This error has been exploded by a knowledge of the 
tact, that salivation rarely occurs while fever runs high, and that 
on its decline the effect of mercury extensively given, will be 
manifested in this way. With the same propriety, the decline 
of fever may be attributed to the perspiration which breaks out 
at this time, when in truth, its abatement leads to the cutaneous 
transpiration. 

Hepatic stimulants, or remedies promoting the secretion of 
bile, sometimes called cholagogues, are useful in functional de- 
rangement of the liver leading to various forms of disease in the 
digestive organs. Colo-rectitis, or dysentery, and enteritis, man- 
ifested in ordinary dysenteric or diarrhceal discharges, often re- 
sult from this form of biliary derangement — from obstruction of 
the portal circulation — and hence hepatic stimulants become val- 
uable therapeutic agents in their treatment. Imperfect diges- 
tion, giving rise to numerous unpleasant symptoms, is often the 
result of inactivity of the liver, and may be remedied by pro- 
moting the hepatic secretion. 

Catalogue of Hepatico-Salivary Stimulants. 
Hydrargyrum. 

Hydrargyrum — Mercury. 

Upon the preparations of this metal do therapeutists mainly 
rely for the speedy production of the physiological action in 
question. The drug and its preparations have previously been 
noticed, under the head of cathartics and catalytics. All of its 
preparations capable of being absorbed have an elective action 
on the liver, and a perceptible impression on the organ is induced 
by less amount than is required to produce ptyalism. As the 
latter action is perhaps never called for, the patient should not be 
annoyed with inflamed gums in order to get the desired chola- 
gogue result. 

Recent investigations, made with the view of determining the 
cholagogue effect of mercury, satisfied the investigator that the 
amount of bile is not perceptibly increased by the remedy, and 



350 * ACOLOGY 

that this long-cherished theory is a fallacy. A report of* thesi 
experiments was made at the annual meeting for 187-5 of the 
Medical Association of Georgia, in which a conclusion is based 

on experiments made with a healthy animal. Now, the want of 
adherence to a proper classification of remedies — that which re- 
cognizes only their physiological action- -leads to much confusion 
and error. If we consider mercury a hepatic stimulant, without 
regard to circumstances or condition of the organ, the result of 
said experiments are perfectly consistent with the old theory. 
They were made while the liver was in full vigor and activity, 
and, of course, when the function was at its greatest perfection. 
Whatever excites it beyond this already healthy point, must of 
necessity interfere with the normal function by over-excitement, 
as in ordinary irritation or inflammation. Hence, as should be 
expected of a hepatic stimulant, it was found that the quantity 
of bile was not increased, but even lessened by mercury. Had 
the test been made on a liver deficient in the secretion, from 
want of sufficient excitement — the pathological condition in 
which the remedy is required — the result would doubtless have 
been different. A cholagogue result may be expected from the 
action of such remedy, only when the liver is below the normal 
standard of excitement. 

In all acute diseases, the treatment of which requires this 
physiological action upon the liver, mercury in some form is 
generally relied on. 

It is unnecessary again to describe the various preparations. 
Suffice it to say, the milder simple forms are preferable for this 
purpose. 

Pilula Hydrargyri — Pill of Mercury — Blue Mass — is in a 
convenient form for administration, and answers the purpose of 
a hepatic stimulant, in the dose of five or six grains. In general 
disturbance of the digestive organs from torpid liver, it may be 
repeated two or three times at intervals of four to forty-eight 
hours, according to the susceptibility of the patient. The same 
may be said of chronic affections of any kind requiring its use. 
/ For the treatment of acute disease, originating in hepatic torpor 
and functional derangement, the same quantity may be given, 



AND THERAPEUTICS. 351 

but repeated every four to six hours. Other preparations answer 
for this purpose in doses proportioned to their activity. 

Protochloride of Mercury — Calomel — in the dose of half a grain 
to a grain, excites the liver to the secretion of bile, in proper 
quantity, when the function is deranged from want of vigor and 
activity in the organ. This quantity, however, given repeatedly 
in enteritis, is likely to aggravate the disease, particularly when 
the liver no longer requires the stimulating effect of mercury. 
This may depend upon chemical changes produced in the remedy 
by coming in contact with free chlorine, so as to form the bichlo- 
ride, a local irritant. Enough chlorine or hydrochloric acid, 
however, is not likely to be met with in the canal to form this 
irritating salt, when a much larger quantity of calomel is given, 
and hence no such effect is had by twenty or more grains. 

CLASS II. 

HEPATIC TONICS. 

This class bears the same relation to hepatic stimulants that 
other tonics do to temporary excitants of the same organ. The 
former promote speedily the secretion of bile, but from them the 
liver receives no permanent energy; but the tonics now under 
consideration give lasting vigor, necessary to a healthy state of 
its function after their use has been suspended. 

They are too tardy in making their impression to be relied on in 
acute disease, dependent on hepatic debility, and the more speedy 
action of a stimulant is necessary first, even though the tonic be 
advised afterward or in connection with it. 

Catalogue of Hepatic Topics. 

Acida Minerales, 
Taraxacum, 

Acida Minerales — Mineral Adds. 

These have been described under the head of digestive tonics, 
a class intimately connected in their therapeutic results with that 
now being considered. It is there stated that digestion is rarely 



352 ACOLOQY 

found deranged without hepatic disturbance also, and vice versa. 
Therefore these acids, being digestive and hepatic tonics, are gen- 
erally given with an eye t<» therapeutic results in both of these 
organs. Their action upon the liver is tonic with cholagogue 
results, slow in inception, and permanent when had. They are 
useful, therefore, only in permanent or chronic functional de- 
rangement of the liver. Whether the most prominent result of 
that derangement be chronic dysentery, diarrhoea or dyspepsia, 
the acids are equally applicable. 

Acidum Sulphuricum — Sulphuric Acid — is perhaps less used 
with a view of affecting the liver than any of these agents, but, 
as stated in a previous part of the work, is peculiarly service- 
able in certain conditions of the stomaeh. The form of 

Acidum Sulphuricum Aromaticum — Aromatic Sulphuric Acid — 
Elixir of Vitriol — is that in which it is most conveniently and 
profitably given. The dose of this preparation is ten drops, well 
diluted with water to prevent injury to the teeth, the enamel of 
which is likely to be corroded by it. 

Acidum Nitricum — Nitric Acid — is better adapted to the treat- 
ment of torpid liver, and may be given in the dose of two drops, 
well diluted with water, for the reason just given. 

Acidum Muriaticum — Muriatic Acid — also a valuable tonic, 
gives invigoration to the liver in the dose of six drops three times 
a day. A combination of the last named acids is perhaps the 
most valuable hepatic tonic, and is known as 

Acidum Nitromuriaticum — Nitromuriatic Acid. In this form 
the two acids are given internally, and applied to the surface 
also. The dose is about four drops, diluted with two fluidounces 
of water, and as an external application the proportion of a fluid- 
ounce or two to the gallon of water, answers the purpose of a 
foot-bath and sponging. This mixture has the most salutary 
effect in chronic debility of the biliary apparatus when used in 
these various modes. A deep narrow vessel, of size sufficient to 
contain only the feet and legs, answers well for the foot bath, 
which should be used for a few moments morning and night, 
and at the same time, if desirable, the whole body may be 
sponged with this diluted acid. 



AND THERAPEUTICS. 



353 



For the internal use of any mineral acid, dilution and other 
precautionary measures are necessary to protect the teeth against 
its destructive action. A want of care in this particular, has 
led to very unpleasant effects, in depriving the invalid of very 
important means connected with the process of digestion. 

Taraxacum — Dandelion. 

The root of Taraxacum dens-leonis, is an herbaceous plant, with 
perennial root, found throughout this country. The leaves spring 
from the upper part of the root, and from their midst the flower 
stem shoots to the height of six or eight inches. The root should 
be gathered in autumn to insure its activity. 



Fig. 36 




Taraxacum 



-leonis. 



Dandelion is represented by observers as a valuable tonic chol- 
agogue — useful in deficient biliary secretion, with debility of the 
digestive organs proper. So far as is known of it, this article is 
an exception to the rule that hepatic stimulants and tonics act 
also upon the salivary glands. 

It has been used in the various diseases connected with the 
digestive organs, of a chronic character, when the probable 
origin is in functional hepatic derangement. It may be given 
in the form of 

Infusum Taraxaei — Infusion of Taraxacum — made by macer- 
ating or digesting, for two hours, two troyounces of the root in 
a pint of water. The dose is two fluidounces. 
23 



354 ACOLOGY 

Exbraxstwm Taraxad — Extract of Taraxacwm — is an officinal 
preparation, but subject to deterioration from time, and there- 
fore not reliable after being kept a year (U. S. D.) The dose is 

about tliirty grains three times a day. 

CLASS III 

RENAL STIMULANTS. 

All agents that tend to increase the secretion of urine in any 
condition of the kidneys, have been usually arranged in a class 
called diuretics, but it is only such as affect these organs by an 
elective stimulant action upon the kidneys themselves, directly, 
or through the mucous membrane, that come properly under 
the head of renal stimulants. Some articles of the class of 
remedies acting as excitants to the mucous membranes gener- 
ally, already described, stimulate the kidneys through their inti- 
mate connection with this membrane, increase the quantity of 
urine under certain circumstances, and are usually termed diuretics. 
The diuretic result of any action is, of course, conditional. De- 
mulcent drinMfe, given during the suppression of this secretion 
by inflammatory action in the kidneys, moderate the over-excite- 
ment, and thereby promote their function. Counter-irritation, 
depletion, etc., have the same effect under similar circumstances, 
but cannot, of course, be termed invariable diuretics. 

In a strictly physiological classification, remedies which act 
directly and electively upon the mucous membranes, and by con- 
tiguity excite the kidneys to functional activity, could not, with 
propriety, it would seem, be called renal stimulants; yet, as this 
membrane upon which they act is so intimately connected with the 
structure of these organs, they may be said to act on the kidneys 
themselves, and therefore may also be mentioned in the class 
under consideration. From what has been said, there would 
seem to be a practical necessity for a division of the remedies 
called diuretics, into as many classes as there are physiological 
actions produced by them. We find three of these, viz: renal 
stimulants, sedatives, and tonics. 



AND THERAPEUTICS. 355 

The articles which we place in the class of stimulants are not 
physiological or direct diuretics, and only under particular cir- 
cumstances will this result or therapeutic effect follow their 
action. 

Renal stimulants are only applicable when a want of excite- 
ment exists, leading to deranged function of the kidneys, and 
consequent functional and structural disturbance in other parts of 
the body. The necessary excitement afforded by such remedies 
under these circumstances, causes increased diuresis. When, 
however, the function ceases to be performed on account of in- 
flammatory excitement, the class of renal stimulants will only 
tend to aggravate the disturbing cause. Not only is the func- 
tion of the kidneys disturbed by a want of circulation and en- 
ergy in them, but relaxation and ill-conditioned lesions occur not 
only in the organs but in the excretory canals, from this cause, 
and the excitement produced by renal stimulants proves useful 
in such conditions of these parts also. 

While all the articles which act upon the mucous membranes 
do, to some extent, affect the kidneys, yet those only are included 
which give evidence of decided action in this way. Only a part, 
therefore, of general blennymenal stimulants are placed in the 
class of renal excitants. 

The stimulation given by the articles we shall arrange in this 
class may not depend entirely upon their elective action upon 
mucous membranes generally, but perhaps to some extent upon 
a special elective influence exercised over the kidneys and their 
appendages. 

Catalogue of Renal Stimulants. 

Oleum Terebinthinse, Juniperus, 

Cantharsis, Sabina, 

Copaiba. 

Oleum Terebinthin^ — Oil of Turpentine. 

This has been noticed as a leading article in the class of blen- 
nymenal stimulants, and doubtless its elective action upon the 
extensive surface of mucous membrane connected with the kid- 



356 ACOLOC.Y 

neys, excretory can:. Is, Madder and urethra, affords a larger por- 
tion of the stimulation given these organs by turpentine. The 
function of the glands, however, is bo materially influenced by 
it, that a place in the class of agents affecting them directly is 
not inappropriate. The kidneys are always more or less excited 
by this remedy, and, when below the normal standard of activity, 
may he stimulated by it to the proper degree; but when already 
above the healthy point, the abnormal condition is aggravated. 
Chronic nephritis, denoted by functional depression, blenorrhua, 
etc., may be greatly relieved by the healthy vigor given by this 
stimulant. The dose is about twenty drops three times a day, or 
more frequently, if necessary. 

Cantharis — Cantharides. 

The body of Cantharis Vesicatoria, or Spanish Flies, described 
under the head of vesicants. 

Cantharides constitute one of the most powerful renal stimu- 
lants, in large doses, exciting the urinary organs to dangerous 
inflammation. Their poisonous effect consists of this state, which, 
when excessive, may lead to fatal results. On account of the 
high excitement created by this remedy in the urinary organs, 
and also in the genital apparatus, the functions of the latter are 
greatly heightened in degree. Its effects in this way, however, 
have been greatly magnified, and base persons, with the view of 
exciting lascivious desires in the opposite sex, beyond the control 
of ordinary prudence, have contrived to have cantharides taken 
in amount sufficient to produce the poisonous effects. When 
taken in substance, the irritating properties are also visible on 
the surface of the alimentary canal, from its local action on the 
mucous membrane in passing over it. 

Its usefulness as a stimulant of the urinary organs consists in 
the excitement given to the kidneys, bladder and urethra, in 
disease connected with relaxation and debility. Feebleness in 
the contractile power of the bladder, from debility in the organ, 
leading to retention of urine, and sometimes incontinence, is 
greatly benefited by this stimulant. The latter symptom, how- 



AND THERAPEUTICS. 357 

ever, must not be mistaken for that arising from excessive irrita- 
tion and inflammation in the neck of the bladder. A mistake 
of this kind may lead to aggravation and prolongation of the 
symptoms. 

Spanish flies are perhaps never administered in substance. 

Tiiictura Cantharis — Tincture of Cantharides — is the proper 
form for internal use, and may be given in the dose of twenty drops 
three times a day, till slight strangury appears, as evidence of 
of its elective effect upon the organs. 

Juniperus — Juniper. 

The fruit of Juniperus Communis, an evergreen shrub, native 
of Europe, but cultivated in this country. The berries are of 
warm terebinthinate taste, and somewhat aromatic, peculiar 
odor. 

They are stimulating to the kidneys, exciting them, when 
given in moderate quantity, to increased secretion of urine, which, 
under the action of the remedy, emits a peculiar odor, compared 
to that of violets. In overdoses, juniper creates high excitement 
in the kidneys and urinary passages, amounting to inflammatory 
action, though not to the extent of that from cantharides. 

Its virtues reside in a volatile oil, obtained from the dried 
berries by distillation. They may be given in substance or in- 
fusion, but the effects may be had from 

Oleum Juniper i — Oil of Juniper — and in this form the activity 
is effectually preserved for any desirable length of time. The 
dose is fifteen drops three times a day. 

S abina — Savin. 

The tops of Juniperus Sabina, an evergreen shrub, native of 
the south of Europe, and is said to grow also in the northern 
part of this country. Savin is an excitant of the urinary and 
procreative organs, and is also an active local irritant, and 
may, therefore, lead to more serious consequences from its action 
upon the stomach and bowels, in overdoses, than from the elec- 
tive action upon the urinary organs. Its activity depends upon 
a volatile oil, and in this form is most conveniently given. 



358 AcoLoar 

Oleum SabincE — Oil of Sarin — is obtained by distillation, and 
may be given in the dose of three or four drops. 

Copaiba — Copa int. 

The juice or oleo-resin obtained from Copaifera Mullijuga, and 
other species of copaifera, native of South America (U. S. P.) 

This balsamic exudation is obtained by making incisions in the 
trunk of the tree, and is, when fresh and pure, a clear, trans- 
parent fluid, of peculiar odor, and somewhat warm, unpleasant 
taste. It is gently stimulating to the urinary organs, and in irri- 
table condition of the kidneys or bladder may lead to painful 
excitement. 

This stimulant is supposed to exercise special remedial power 
over gonorrhoea, and has, for a great while, and until the last few 
years, been looked upon as the sine qua non in its treatment. It 
is now somewhat uncertain whether benefit is derived from it 
other than the increase and consequent dilution of the urine, 
which causes less injury to the irritable mucous membrane of the 
urethra than when of small quantity and acrid. Like other ex- 
citants, it doubtless changes the nature of the existing specific 
inflammation when applied to it, but will certainly effect more 
in this way by its local application to the part, and when used 
with the view of making any direct impression, should certainly 
be injected into the urethra. The dose is half afluidrachm three 
times a day, alone or in the form of emulsion. 



CLASS IV. 

RENAL SEDATIVES. 

Another variety of "diuretics/' so-called, affect the urinary 
organs in an opposite manner to that of the preceding class; 
and although having direct antagonism with renal stimulants, 
are usually associated with them in a common class called diu- 
retics. In a physiological classification, sedatives and stimulants 
cannot be placed in the same class, and the practical advantage 
of this course to the learner is obvious. To learn the names of 



AND THERAPEUTICS. 359 

renal stimulants, sedatives and tonics merely as a class of "diu- 
retics" may, as we have seen, lead to an improper conception of 
their action, and to grave errors in practice. For example, if, 
in deficient diuresis from over-excitement of the renal organs, 
cantharides, turpentine, and other stimulating articles be given, 
the difficulty will evidently be increased. The same may be said 
of sedatives, when used in the opposite condition of the organs. 
Renal sedatives tend to allay heat and excitement of the kidneys 
and urinary passages, and thereby promote their function, when 
deranged from this cause. In nephritis, cystitis, and like condi- 
tions of the passages, the cooling, sedative and soothing influ- 
ence of renal sedatives are often salutary in their results. The 
urine is generally scant and acrid under such circumstances, and 
as the excitement of the kidneys is allayed by them, it becomes 
more abundant and less irritating to the inflamed excretory ducts. 
They indeed become useful diuretics in such cases. The same 
may be said of their use in febrile affections, when the kidneys 
and their appendages, along with other important organs of the 
body, are in a state of preternatural heat and excitement. 

Catalogue of Renal Sedatives. 

Potassii Nitras, 
Potassii Bitartras, 
Spiritus iEtheris Nitrosi. 

Potassii Nitras — Nitrate of Potassium. 

A description of this salt has been given in the class of car- 
diac sedatives, and its general sedative and refrigerating influence 
on other parts also alluded to. Although, according to observ- 
ers, nitre increases the secretion of urine in a normal condition 
of the kidneys, yet its effects in this way are doubtless more de- 
cided when they are in an irritable or inflamed condition. Dur- 
ing the exacerbation of autumnal fevers, when functional dis- 
turbance, heat and excitement pervade the whole organism, it 
serves as a general refrigerator and diuretic. In the dose of Jive 
to ten grains every two or three hours, nitrate of potassium has a 



360 ACOLOGY 

refrigerating effect upon the urinary apparatus, causing incr 
of urine in excitement of the organs. 

Potassi Bitartras — Bitartratc of Potassium. 

Crude .tartar is deposited in the fermentation of wines, and 
this, when purified, forms the salt in question. Cream of tartar, 
as it is familiarly known, has, in addition to its sedative influ- 
ence upon the kidneys and consequent escape of fluids in that 
direction, a decided tendency to promote enteric exhalation and 
watery alvine evacuations. The acid taste of the salt, being grate- 
ful to the patient under febrile excitement, serves as a beverage, 
while its sedative and refrigerant influence over the kidneys and 
other organs, makes it a useful remedy. In nephritic inflamma- 
tion, it is peculiarly applicable, on account of the hydragogue 
catharsis which results from large doses, in addition to the direct 
effect upon the diseased organs. The diuretic effect which gen- 
erally results from its action, and the watery discharges from 
the bowels, have a kind of depleting influence highly favorable 
in ascites, anasarca, and the like, on account of the demand in 
the blood vessels, caused by these drains upon the circulation, 
favoring absorption and retarding effusion. Its effects in this 
way are particularly desirable in plethoric subjects, or when fe- 
brile excitement exists. It may be given in the dose of a drachm 
or two, three times a day, dissolved in water. 

Spiritus iETHERis Nitrosi — Spirit of Nitrous Ether. 

This is a volatile, slightly yellowish colored fluid, of agreeable 
odor and sweetish, rather pungent taste. It is often found adul- 
terated with water and alcohol to a degree that interferes with its 
usual medicinal effects. In addition to the soothing sedative 
action of this remedy upon the urinary organs, it is supposed to 
possess decidedly anodyne properties, and is, therefore, extensively 
used in febrile affections for its general quieting effect and sooth- 
ing diuretic action. 

Temporary irritability in the neck of the bladder, causing 
dysuria in the form of strangury, is generally very promptly 



AND THERAPEUTICS. 361 

relieved by sweet spirit of nitre. This is particularly the result, 
when used with paregoric or other fluid preparation of opium ; 
and not only in strangury is this preparation soothing, but pain- 
ful inflammatory conditions of the urinary organs generally are 
relieved by it. 

Spirit of nitre may be given in the dose of one fluidrachm, di- 
luted with a little water, and repeated every two or three hours, 
if necessary. 

CLASS V. 

RENAL TONICS. 

The articles of this class increase the vigor of organs upon 
which they act — not only when in a state of debility, but even 
in a healthy condition, the ordinary amount of urine secreted 
may be sometimes increased. They are, therefore, elective rem- 
edies, acting upon the kidneys neither as a stimulant or sedative, 
but in a way to give direct energy to the organs in the perform- 
ance of their function. These may, with some propriety, be 
called diuretics. Inasmuch as the term tonic, when applied to 
the action of remedies on an organ, is always understood to mean 
the power of giving energy, more or less permanent, to its func- 
tion, it certainly, in this case, carries with it the idea of increased 
diuretic action. When, however, by the name of a class the 
particular action is described, and the organ upon which it is 
exerted, evidently the result, which is never positively certain, 
need not be included. 

Renal tonics are often used in a normal state of the kidneys, 
in order to reach, by a chain of indirect influences, a therapeutic 
result on dropsical accumulations. These, involving the circu- 
latory and absorbent systems, have already been alluded to, en 
passant, under the head of sedative diuretics. 

They are used as direct therapeutic agents in the treatment of 
chronic renal disturbance dependent on functional debility. At 
the conclusion of acute or organic disease of the kidneys, and 
even during its progress, support to the secreting power often 
becomes necessary. These means do not, to the extent of exci- 



362 AOOLOG 

tants, aggravate existing inflammatory notion, and may be used 
with advantage where the latter would be highly injurious. 

Catalogue of Renal Tonics. 

Scilla, Digitalis, 

Uva Ursi, Buchu, 

Tinctura Ferri Chloridi. 

Scilla — Squill. 

The bulb of Scilla Maritima sliced and dried (U. S. Br.) It 
is kept in this form, and also that of powder, which requires to 
be protected from moisture of the atmosphere, for which it has 
great affinity. It is only as a renal tonic that any very decided 
results are expected. From its reputed action upon the organs, 
connected with the three great mucous surfaces of the body, a 
kind of blennymenal influence might be inferred, more particu- 
larly on account of its popularity as an expectorant; but squill, 
like many other remedies, has doubtless been used more for the 
convenience of its preparations than any emetic or expectorant 
effect ever observed in it. Into all the syrups taking its name, 
other ingredients enter, and to them doubtless are due most of 
the relaxing and expectorant effects attributed to the squill. The 
irritable bronchia are soothed and a distressing cough allayed by 
the different syrups of squill with certainty when, and only ichen, 
morphia or some other opiate preparation is added. For its 
effect as a renal tonic these additions are not necessary. As a 
means of augmenting the function of the glands to effect some 
ulterior therapeutic result, squill is considered valuable, and free 
from liability to injurious action in either depressed or excited 
state of the organs, or of the system generally. 

When given alone, or incorporated with other solid substances, 
the pulverized squill may be given in the form of pill, in the 
dose of one or two grains. 

Syrupus Scillce — Syrup of Squill. This is a convenient and 
pleasant preparation when the remedy is used alone or in con_ 
nection with other fluid preparations; and may be given in the 
dose of one or two fluidrachms. 



AND THERAPEUTICS. 363 

Digitalis. 

The leaves of Digitalis Purpurea, which, with their preparations, 
have already been described in the class of cardiac tonics. As 
there stated, erroneous views have been entertained in regard to 
the physiological action of this remedy, and of its cumulative 
poisonous effects in ordinary doses. Its calming influence upon 
the heart when in an irritable condition, led to the belief that its 
action was purely sedative, such as would entitle it to a place in 
the class of "arterial" or "cardiac" sedatives, but while it was 
not, like other cardiac sedatives, found useful in inflammatory 
diseases, the chief reliance is in general debility. 

As a diuretic, its use is also confined to cases of asthenic char- 
acter, in which tone or permanent vigor to the organs generally 
is required. Digitalis has been found useful therefore when, 
from an impoverished state of the blood, anasarcous and other 
dropsical collections occur. These effusions are particularly lia- 
ble to take place when the kidneys fail to perform their func- 
tion, and by restoring vigor to these organs the accumulations 
are not only prevented, but the amount already effused is less- 
ened by the depleting effect of diuresis. While depletion of 
the blood vessels prevents, the opposite condition facilitates, ab- 
sorption, and this drain upon the blood vessels makes a demand 
for fluids which the absorbents readily supply from the dropsical 
collections. 

Digitalis is slow in making any functional change in the kid- 
neys, but, when possessed of its usual activity, does so more cer- 
tainly and powerfully than any renal tonic used for this pur- 
pose. In hydrothorax and other dropsical effusions, it is usually 
given in connection with squill, for their combined tonic impres- 
sion upon the kidneys, with such other remedies as may be found 
necessary to remove the prime cause of disturbance. This often 
exists in the heart, and digitalis frequently serves to counteract 
the results, and also affords radical relief to the diseased organ 
primarily at fault. 

When the secretion of urine is deficient from disease of the 
kidneys themselves, leading to various forms of constitutional 
disturbance, digitalis may also be found serviceable. 



364 



ACOLOGY 



The dose, in substance, is one or two grains of the pulverized 
leaves made into the form of pill. 

T/nrfurii Digitalis — Tmctwre of Digitalis — may be given in the 
dose of ten to fifteen drops three limes a day. 

Uva Ursi. 



Fig. 37 



The leaves of Arctostaphylos Uva Ursi, an evergreen shrub, 
native of Asia, Europe, and the northern part of this country. 
(U. S. D.) The dried leaves are astringent and bitter, with very 
little odor; are said to have digestive tonic properties, and to 
this has been attributed, doubtless improperly, all the tonic action 
supposed to be exerted upon the kidneys. 

The tonic effect produced by 
uva ursi, possessed as it is of de- 
cided astringency, proves particu- 
larly serviceable in chronic in- 
flammation or ulceration of the 
kidneys and urinary passages, 
leading to catarrh of the bladder 
or blenorrhcea. It is also re- 
commended in diabetes, with a 
view of giving proper tone to 
the deranged function of the kid- 
neys. Debility of the organs from 
any cause would seem to author- 
ize its use, since no injurious ex- 
citement is given by it even in 
inflammatory condition. 

Uva ursi is rarely used in sub- 
stance, but the powdered leaves 

S iwns. aUther ' Sh ° WiUg ma ) r be taken in the dose of twenty 
to thirty grains. 
Decoctum Uvaz Ursi — Decoction of Uva Ursi — is prepared so 
that an ounce of the bruised leaves shall make a pint of decoc- 
tion. The dose of this is two or three fluidounccs three times 
a day. 




Arctostaphylos uva ursi 
1. Anthers. 2. 



AND THERAPEUTICS. 365 

Eviractum Uvce TJrsi Fluidum — Muid Extract of Uva TJrsi — is 
a very convenient preparation of the remedy, and that in which 
it is generally used. The dose is from a half to afluidrachm. 

Buchu. 

The leaves of Barosma crenata, and other species of Barosma, 
growing at the Cape of Good Hope (U. S. D.) The leaves are 
about an inch long, and half an inch broad. They have strong 
aromatic odor and bitter taste. 

Buchu, although a tonic to the kidneys, increasing their secre- 
tion of urine and invigorating the organ when depressed from 
any cause, has been considered more particularly useful in debil- 
ity of the bladder from disease leading to strangury, inconti- 
nence of urine, blenorrhoea, etc. Nostrum venders acquire 
princely fortunes from the sale of their lauded preparations of 
this remedy. While extravagant praise has thus been bestowed 
upon it for mercenary purposes, the practitioner should not be 
so disgusted as to disregard the just claims of buchu as a reme- 
dial agent, and suffer an article of so much reputed value to fall 
into professional disuse. Thirty grains of the powdered leaves 
may be given when used in substance. 

An Infusion, made with a troyounce of the bruised leaves to 
a pint of hot water, may be given in the dose of two or three fluid- 
ounces three times a day. 

Extractum Buchu Fluidum — Fluid Extract of Buchu — is in 
common use, and answers well for administration of the remedy. 
The dose is half a fluidrachm in water. 

Tinctura Ferri Chloridi — Tincture of Chloride of Iron. 

This tincture answers well as a form in which to preserve 
permanently the chloride of iron. In the solid form it is sub- 
ject to deliquescence, and in watery solution to decomposition. 
The tincture has the odor of chloric ether, an acrid, styptic 
taste, and is of a reddish-brown color from reflected, and yellow- 
ish from transmitted light. 

While tincture of the chloride of iron has the usual effects of 



366 ACOLOGY 

other preparations of iron upon the system, and is thus used, it 
is supposed, to have also special tonic action upon the urinary 
organs, [ts known powerfully astringent and styptic properties 
arc not unfavorable to the opinion entertained of its restoring 

and tonic effect upon the kidneys and bladder, when in a state of 
relaxation and debility from chronic inflammation and ulceration. 
Moreover, its decided tendency to promote diuresis being a well 
established fact, its characteristic property, above given, leads to 
the belief that the effect upon the kidneys is that of tonic. It 
may be used in all cases of mucous discharge from the bladder, 
kidneys or urinary passages from debility or chronic disease of 
any kind. 

The dose is fifteen to twenty drops, gradually increased to a 
fluidrachm three times a day, well diluted. A w r ant of attention 
in its administration may lead to caries of the teeth from destruc- 
tion of the enamel, as by mineral acids. 



DIVISION IV. 

REMEDIES THAT AFFECT THE PROCREATIVE ORGANS. 

Some difficulty is experienced in arranging the classes of this 
division, owing to the dissimilarity of the male and female or- 
gans of generation. While both sexes contribute material to- 
ward the production of a new creature, the organs in each, which 
directly supply it, differ in their conformation and the manner of 
action in affording such material. In them, however, there are 
points of similarity. Though, in the male, regularly consti- 
tuted glands exist, differing from the germ producing organs of 
the female, yet in both they are in pairs and furnish, by a pro- 
cess resembling secretion, and convey through tubes to a recep- 
tacle in each, their quota toward the living germ of a new being. 
In the female, this is periodical, and in the male, only at times 
and under circumstances favoring a union of the two ingre- 
dients. The genital organs are immediately concerned in the 



AND THERAPEUTICS. 367 

production of these materials and their conveyance to the com- 
mon receptacle in the female. The classes of remedies acting 
upon these genitals are named accordingly; while those acting 
on the receptacle or womb, an organ only passive in the above 
process, have the term uterine prefixed. 



CLASS I. 

GENITAL STIMULANTS. 

The control exercised by certain medicinal agents over the 
venereal organs of both sexes, has long been recognized by med- 
ical writers; and while it is evident that the incentive to venery 
is increased by some and lessened by other remedies, there is no 
doubt that highly wrought pictures of uncontrollable propensity 
have been made from actions purely imaginary. 

Remedies which cause an increase of blood to the genital or- 
gans, and consequent heat and excitement, also give increased 
activity to the function of the testicle of the male, and have 
hence been called aphrodisiacs. Some of them, although they 
have no elective action specially upon the glands or ovaries them- 
selves, but upon the genitals generally, in the manner just stated, 
may, with some degree of propriety, be called genital stimulants 
or excitants. These stimulants rarely subserve any valuable 
therapeutic purposes. Occasionally, however, when from disease 
excessive venery, self-pollution, etc., a want of vigor in these parts 
exists, they may prove beneficial. In cases of impotence, arising 
from the latter cause, their use may be unprofitable and even in- 
jurious, unless the enervating and degrading habit be suspended. 
If it be continued, the remedies only afford the means of more 
complete moral and physical destruction ultimately. Moreover, 
should the patient cease the actual commission of excesses, with- 
out the observance of general rules for mental, moral and physi- 
cal invigoration, genital stimulants answer no valuable purpose. 

The class of renal stimulants is said to excite also the vene- 
real or genital organs, but this influence is not very decided, 
except in the action of one or two articles only. 



368 ACOLOGY 

Catalogue of Genital Stimulants. 

Cantharis, 
Cannabis [ndica. 

CANTHAJU S — Cantharides. 

This drug, noticed as one of the most powerful renal stimu- 
lants, is also a leading article of this class. It not only affects 
parts intimately connected with the urethra of both sexes, but 
the organs directly concerned in the production of a living germ 
for the new being. Whether this is the result of urethral irri- 
tation and excitement from "sympathy of contiguity," or from 
direct elective influence, is a question of doubt. The fact, how- 
ever, that cantharides affect the venereal as well as the renal 
portion of the urinary apparatus, is generally admitted. If it 
be not a genital stimulant, physiologically speaking, upon what 
grounds can it be claimed as a renal stimulant? If, as has been 
suggested, its elective direct action is exerted upon the mucous 
membrane alone, why should it not be called a procreative as well 
as renal stimulant, and why should it not be found to affect the 
respiratory mucous membrane also ? The renal and procreative 
organs, being closely connected in both sexes, are alike affected 
by this remedy. The womb itself is not exempt from the gen- 
eral excitement given these organs; for, while it does not seem to 
influence directly the function of contraction, yet the heat and 
excitement produced, will lead to contraction in the gravid uterus, 
with the expulsion of its contents. 

The Tincture, as stated under the head of renal stimulants, is 
the usual preparation for internal use, in the dose of twenty drops 
three times a day till slight strangury is produced. 

Turpentine, savin and copaiva have, in some degree, this effect 
upon the organs of generation, but so slight as not to warrant a 
prominent place in the class. 

Cannabis Indica — Indian Hemp. 

As to the aphrodisiac effects of hemp, different observers agree, 
but of the manner in which such symptoms are produced, there 



AND THERAPEUTICS. 369 

may be some difference of opinion. Its action upon the nervous 
system has already been described, and to this some attribute all 
the excitement produced in the genital organs by hemp; but un- 
less the nerves supplying these parts be specially impressed by 
the remedy — of which we have no evidence — there is no good 
reason to suppose that these would be more aifected than other 
organs by this general neurotic. The same preparations and 
doses may be given as laid down for cerebral stimulants. 

Phosphorus is believed to have invigorating influence upon 
these organs, but its tonic effect upon the great nervous centre is 
perhaps sufficient to account for this, as all other parts of the 
body are equally affected by its use. 

CLASS II. 

GENITAL SEDATIVES. 

Diseases connected with the organs of generation, of a sthenic 
character, are more frequently met with than those of the oppo- 
site variety, and hence genital sedatives are demanded more 
frequently than excitants. Indeed, that state of debility follow- 
ing acute disease, and for which stimulants ultimately become 
necessary, may be prevented by the timely use of such sedative 
measures as are necessary to arrest the inflammatory action before 
its injurious results have been produced. Gonorrhoea, orchitis, 
etc., when unrestrained, lead not only to protracted functional 
derangement, but to a train of annoying and tedious organic 
lesions. 

Catalogue of Genital Sedatives. 

Gelsemium, 

Lupulin. 

Camphora. 

Gelsemium — Yellow Jasmine. 

The root of Gelsemium Sempervirens, a climbing plant, de- 
scribed under the head of spinal sedatives. 

Yellow jasmine, as stated under the proper head, is a spinal or 
nervous sedative, and as such, of course, indirectly depresses the 
24 



370 ACOLOGY 

functions of organs generally, with a few exceptions. Of this 
depression the genitals partake in a large degree; indeed, to the 
extent of warranting the conclusion that gelsemium has some 
special elective influence over these organs independently of the 

influence exerted upon the spinal nerves. Hence, its position in 
the class under consideration. 

It will be found useful in excessive excitement of the urethra, 
ovaries and testicles from any cause, and observers of its effects 
mention favorably the use made of it in gonorrhoea. Doubtless 
venereal excitement, and even orchitis and ovaritis, come more 
directly under its control, and for these the remedy may be given 
with prospect of benefit. 

The Tincture, as recommended in the class of nervous sedatives, 
may be used for its anaphrodisiac effect and general sedative in- 
fluence upon the genital organs, in the dose of twenty drops, re- 
peated according to circumstances. 

Lupulina — Lupulin. 

A granular powder obtained from the strobiles of Humulus 
Lupulus, or Hop Vine, a twining herbaceous plant, with peren- 
nial root, cultivated extensively in many parts of the United 
States and Europe, for the hops of which beer is made. 

Lupulin is collected by threshing or rubbing hops and sifting 
the powder through a sieve. It is of yellow color, peculiar 
odor and bitter taste. 

The ancients entertained extravagant ideas of the soporific and 
anodyne effects of hops, but at this day the profession recognizes 
them only as a gentle gastric stimulant. Lupulin, however, 
although believed to possess some anodyne property, is appre- 
ciated only as a genital sedative, leading to anaphrodisiac effects. 
Its use in the treatment of gonorrhoea has proved satisfactory, 
particularly when given with the view of allaying the excite- 
ment leading to nocturnal priapism, and the consequent laceration 
of the engorged corpus spongiosum. It may be given with advan- 
tage in preternatural heat and excitement of the organs from any 
cause, or to allay even the usual fervor when it becomes neces- 



AND THERAPEUTICS. 371 

sary to do so in the management of depraved functional disturb- 
ance, such as spermatorrhoea, etc. 

Lupulin, in substance, may be given in the dose of ten grains, 
made into the form of pill; and in order the more certainly to 
give freedom from pain and irritability of the genital organs, 
some preparation of opium is usually given at the same time. 

1 in dura Lupulinoe — Tincture of Lupulin. The virtues of lup- 
ulin to the full extent are contained* in the tincture, and in this 
preparation may be given alone or with other liquid preparations, 
in the dose of two jluidrachms. 

Camphora— Camphor. 

A concrete substance obtained from Camphora Officinarum 
an evergreen tree, native of China, and found also in eastern 
Asia. 

Camphor, when purified by sublimation, is in the form of 
white, brittle mass, and can be readily pulverized by the addi- 
tion of a little alcohol or common spirit. It has been used for 
the supposed anodyne effect, but more particularly as a venereal 
sedative, in connection with lupulin and opium, for the treatment 
of gonorrhoea, spermatorrhoea, etc, in the dose of five grains, made 
into the form of pill. 

CLASS III. 

UTERINE STIMULANTS. 

The uterus, though intimately connected with the venereal 
organs, is not always affected in common with them by remedies. 
This organ is affected by excitants of the procreative system, 
through the sympathy of contiguity, when a neighboring part 
is excited, or by elective influence exerted directly upon it. The 
class now under consideration answers to the latter, and tends 
more to functional than structural excitement. That is to say, 
heat and irritation from th'e afflux of blood to the viscus, such 
as may be communicated to contiguous organs, is not produced 
by the action of remedies in this class. 

The natural functions of the organ are : menstruation, pro- 



372 ACOLOC.Y 

tection and nourishment to the new being, and its expulsion at 
maturity. The last, more particularly, is affected by uterine 
excitants. 

These remedies are required when, in parturition, the contrac- 
tions are not sufficiently active for the ready termination of labor, 
and after delivery, when sufficient firmness does not exist to pre- 
vent hemorrhage, and other unpleasant results from want of 
vigor in the organ. Articles of the class are useful also, and 
become appropriate emmenagogues in relaxed and debilitated 
condition of the womb leading to retention or suppression of the 
catamenia, or dysmenorrhea. 

Catalogue of Uterine Stimulants. 

Ergota, 
Gossypii Radix. 

Ergota — Ergot. 

The defective grains of Secale Cerate, or Common Rye. Ergot 
is supposed to result from fungous growth taking the place of 
the grain in rye. Other cereals are perhaps subject to this form 
of degenerate growth, which probably also possesses similar med- 
icinal properties. It is of dark-brown color externally, yellowish 
within, and has putrid odor and unpleasant, somewhat acrid 
taste. 

The only reliable medicinal property known to ergot is that 
of uterine stimulant, by which the uterine muscular fibre is 
made to contract. The action seems to be an elective influence 
exerted upon this particular structure of the organ, without 
causing unusual heat and excitement of the womb or neighbor- 
ing organs. 

This is called abortive effect, and is called for in tedious labor 
from feeble contractions of the uterine fibre, or other conditions 
such as hemorrhage, etc., dependent upon a want of normal con- 
traction. For amenorrhea, from debility and relaxation, it 
proves also valuable from what is termed its emmenagogue prop- 
erty, but this result doubtless proceeds from the elective action of 



And therapeutiOs. 3?3 

the remedy on the contractile fibre of the uterus. Caution is 
advised in its use as a parturifacient, lest rupture of the womb 
should occur from violent contractions when the os uteri is un- 
yielding. 

Fig. 38. 




Full-grown Ear of Rye, strongly infected loith Ergot (nat. size.) 
a a. Mature Ergot. 

Serious results may doubtless follow the injudicious use of the 
remedy, but when the contraction is already vigorous, a prudent 



374 ACOLOGY 

practitioner would not, of course, see any necessity for its use ? 
and with such caution, no danger need be apprehended. Con- 
traction in the circular fibres, disproportionate to that of the lon- 
gitudinal, is that which retards dilation of the os, and, according 
to the experience of the author, is readily overcome by ergot, 
which is supposed to act more directly upon the longitudinal 
fibres, and thus promote dilation. Pulverized ergot may be 
given in the dose of fifteen grains, and repeated in thirty minutes 
if the effects are not produced. 

Vinum Ergotoz — Wine of Ergot — is a convenient and agree- 
able preparation, one in which the activity of ergot may be more 
perfectly preserved from deterioration by time. The dose is half 
a fliddounce, repeated as above advised for the ergot in substance. 

Tinctura Ergotce — Tincture of Ergot — is officinal, and may be 
used with propriety when the remedy is required. In this form 
also the virtues of ergot may be preserved, and since failures to 
realize the benefit of this drug are doubtless often due to deteri- 
oration of the article from being too long kept in substance, this 
is an important consideration. The dose is one or two fluidrachms 
and repeated, as with other preparations, every thirty minutes 
for its parturient effects, and less frequently for ordinary inac- 
tivity of the womb. 

Gossypii Radicis Cortex — Bark of Cotton Root. 

The bark from the root of Gossypium Herbaceum or Cotton 
Plant. The discovery of medicinal virtues in this plant is of 
comparatively recent date. Indeed, so little was known of it in 
1860, that the United States Pharmacopoeal revision for that 
year gave no officinal preparation of the drug. There is now, 
however, sufficient evidence of its stimulating action upon the 
uterine fibre, from those who have repeatedly witnessed its effects, 
to authorize a reliable preparation in the revision of 1870. 

Gossypium is considered equally prompt and reliable, and a 
much safer remedy than ergot as a parturifacient, and is much 
prized on account of the favorable results obtained from it in 
the treatment of amenorrhea from uterine inactivity. 



AND THERAPEUTICS. 375 

A Decoction may be made with four troyounces of the bark of the 
root to two pints of water, boiled down to a pint ; two or three fluid- 
ounces of which may be taken every thirty minutes till its effects 
are experienced, when required in labor. For its invigoration 
in feeble menstruation, it is given only three or four times a day 
for several days. 

Extraction Gossypii Radicis Fluidum — Fluid Extrcuct of Cot- 
ton Root This is the only officinal preparation of cotton root, 
and may be relied on for the full effects of the drug, as stated for 
other articles of the class, in the dose of one or two fluidrachms. 

In addition to these direct uterine stimulants, there are many 
indirect excitants of the womb, which, under favorable circum- 
stances, influence its contractions, and may sometimes bring about 
desirable therapeutic results. The more active renal and genital 
stimulants are of this description. With no other direct action 
by them than the irritation, heat and excitement produced in the 
urinary apparatus, the uterus, from participation in the afflux of 
blood thus invited to neighboring organs, is, in consequence, the 
subject of more or less excitement, which may result in greatly 
increased functional activity. Hence, cantharides, savin, etc., 
may, when given to a pregnant female, sometimes bring on abor- 
tion. In the same manner, the derangement in menstruation, 
occurring from inactivity of the womb, may be corrected. Sim- 
ilar effect upon the uterus is produced by the action of excitants 
upon the rectum; and aloes, or other elective or local irritant of 
this part, gives indirect stimulus to the womb, and should be used 
with a knowledge of this fact. 

CLASS IV. 

UTERINE SEDATIVES. 

The remedies heretofore relied on to arrest abnormal contrac- 
tion of the womb are, for the most part, indirect agents. Opium 
afforded, for a long time, the chief reliance in threatened abor- 
tion and in uterine hemorrhage from the gravid womb. Its ac- 
tion as a sedative in allaying excitement and expulsive contrac- 
tion is not exerted upon the uterus, but the nervous system, 



376 acoloc; v 

through which irritability, and the contraction dependent thereon, 
arc controlled. Within the past few years direct sedative action 
is claimed for at least one remedy — black haw — hut its reputed 
anodyne effect in neuralgia, etc., leads to the suspicion that it, 
too, is an elective neurotic. 

Catalogue of Uterine Sedatives. 

Viburnum, 
Opium. 

Viburnum — Black Haw. 

The bark of the trunk, branches or root of Viburnum Pruni- 
folium, or Black Haw, a small branching tree, found in the 
southern portion of the United States, and until recently un- 
known as a remedy possessing any very important medicinal 
virtues. The medical profession is indebted to Dr. Fares, of 
Mississippi, for the discovery of valuable uterine sedative prop- 
erties in the bark of this tree. 

Physicians of this city, who have used it as directed by Dr. 
Fares, declare their preference for it, as an antiabortive^ 
above that of opium or other means used for the purpose. It 
has also been found useful in neuralgic pain and general uneasi- 
ness from irritable condition of the womb; acting sometimes 
very promptly as an anodyne in such cases. 

Black haw may be used in the form of decoction, made by two 
troyounces of the bark to two pints of water boiled down one- 
half. Of this, one or two fluidounces may be taken every thirty 
or forty minutes till the sedative effect is had. 

A Fluid Extract is kept by druggists, of which a fluidrachm 
is the proper dose. 

Opium. 

The preparations of this important remedy have for a great 
while been used as the only reliable anti-abortive means at our 
command. Not until the discovery of the quieting influence of 
viburnum was any other special agent relied on to control irritabil- 



AND THERAPEUTICS. oil 

ity of the uterus; and now, the practitioner would not feel that his 
whole duty had been performed in a case of abortion for which 
no opiate had been given. There is a feeling of greater 
security in threatened premature delivery, when this remedy is 
administered in due time. 

While confidence in its restraining influence over premature 
contractions is felt, no fear is now entertained that labor, appear- 
ing regularly at the full period, will be retarded by decided doses. 
Indeed, effective pains are apt to succeed the distressing, irregu- 
lar suffering allayed by opium in the commencement of labor at 
the full time. Full doses of morphine early in threatened abor- 
tion generally prove effectual. 



INDEX 



Ablution, 11. 

Acacia, 130. 

Acacia Catechu 83. 

Acacia Vera, 130. 

Acarus, 117. 

Acetate of Lead, 77, 160. 

Acetate of Morphia, 293. 

Acetated Tincture of Opium, 295. 

Acetum Cantharidis, 72. 

Acetum Lobeliae, 196. 

Acida Minerales, 122, 245, 351. 

Acid Drinks, 268. 

Acids, 23. 

Acidum Arsenicum, 123. 

Acidum Arseniosum, 174. 

Acidum Carbolicum, 93, 126, 162. 

Acidum Chromicum, 123. 

Acidum Gallicum, 81. 

Acidum Hydrocyanicum Dilutum, 273, 

313. 
Acidum Muriaticum, 127, 248, 352. 
Acidum Nitricum, 122, 247, 352. 
Acidum Nitromuriaticum, 249, 352. 
Acidum Sulphuricum, 247, 352. 
Acidum Sulphuricum Aromaticum, 247, 

352. 
Acidum Sulphurosum, 176. 
Acidum Tannicum, 81. 
Acologia, 2. 
Acology, 2. 
Acorus Calamus, 104. 
Action, Modifying circustances of, 49. 
Actual Cautery, 72, 122, 162. 
Acupunctura, 144. 
Acupuncture, 144. 
^Ether, 305, 309. 
Age, 50. 
Air, 9. 

Alcohol, 298. 

Alcoholic Drinks, 105, 299. 
Alexandrian Senna, 217. 
Aloe, 212. 



Aloes, 212. 
Aloe Socotrina, 212. 
Aloe Spicata, 212. 
Aloe Vulgaris, 212. 
Allspice, 106. 
Althaea, 136. 
Althaea Officinale, 136. 
Alum, 78. 
Alumen, 78. 
Amber, 332. 

American Centaury, 245. 
American Columbo, 240. 
American Helebore, 257. 
American Senna, 219. 
Ammonia, 67, 72, 184. 
Ammoniac, 284. 
Ammoniacum, 284. 
Ammoniated Copper, 318. 
Ammonii Bromidum, 321. 
Ammonii Carbonas, 255. 
Ammonii Chloridum, 177. 
Amorphous Crystals, 28. 
Amylum, 135. 

Anaesthetic Cerebral Sedatives, 308. 
Anaesthetic Cerebral Sedatives, Cata- 
logue of, 309. 
Analysis, 22. 
Anger, 3. 

Animal Effluvia, 10. 
Anise, 106. 
Annual Roots, 14. 
Antacida, 180. 
Antacids, 180. 
Anthelmintics, 109. 
Anthelmintics, Catalogue of, 111. 
Antimonial Ointment, 73. 
Antimonii et Potassii Tartras, 196, 266. 
Antiparasitic, 117. 
Antiseptics, 123. 
Antiseptics, Catalogue of, 125. 
Antispasmodics, 326. 
Aperient Evervescing powders, 207. 
379 



380 



INDEX. 



Aperient--. 201. 

Apothecaries' Weights, I 7. 

Approximate Sfeasures, 17. 

Aqua Chlorinii, 127. 

Aqua Portis, L22, 2 17, 852. 

Aqua Elegia, 2 19, 252. 

Arctostaphylos Uva Ursi, 364. 

Argent i Nitras, 90, L68, 818. 

Argent i Nitras Fusa, 90. 

Arnica, 328. 

Arnica Montana, 323. 

Aromatic Local Excitants, 97. 

Aromatic Local Excitants, Catalogiu 

of, 98. 
Aromatic Sulphuric Acid, 247, 352. 
Aromatic Syrup of Rhubarb, 212. 
Arsenic, 17 1. 
Arsenic Acid, 123. 
Arsenicum, 174. 
Arsenious Acid, 174. 
Artemisia Cina, 120. 
Arteriotomy, 260. 
Asclepias, 285. 
Aspidium Felix Mas, 119. 
Assafcetida, 330. 
Astringents, 76. 
Astringents, Catalogue of, 77. 
Atomizer, 41, 88, 91. 
Atropia, 304. 
Atropia Belladonna, 303. 
Attachment, 3. 
Aurantii Cortex, 107. 
Azedarach, 113, 

Balsam of Peru, 280. 
Balsam of Tolu, 279. 
Balsamum Peruvianum, 280. 
Balsamum Tolutanum, 279. 
Bark, 15. 

Bark of Pomegranite root, 113. 
Barosma Crenata, 365. 
Beef Tea, 149, 234. 
Belladonna, 303. 
Belladonna Folia, 303. 
Belladonna Radix, 303. 
Benne, 134. 
Benzoin, 285. 
Berberina, 238. 

Bicarbonate of Potassium, 184. 
Biennial Roots, 14. 
Biniodide of Mercury, 171. 
Bismuthi Subnitras, 137. 
Bitartrate of Potassium, 360. 
Bitter Cucumber, 225. 
Blackberry Root, 81, 82. 
Black Ginger, 100. 
Black Haw, 376. 
Black Oak, 80. 



Black Pepper, 107. 
Black Poppy, 290. 
Black Snakeroot, 8 16. 

Blennymenal Stimulants, 276. 
Blennymenal stimulants, Catalogue of, 

277. 
Blessed Thistle, 319. 
Blistering Paper, 71. 
Blistering Tissue, 71. 
Blisters, 68. 

Blood-Letting, 156, 25!). 
Bloodroot, lit.'!. 
Bloodroot, Powder of, 193. 
Blue Gentian, 243. 
Blue Gum, 282. 
Blue Pill, Mass, 168, 209, 350. 
Bodies, Simple, 21. 
Bran, 250. 
Brayera, 114. 

Brayera Anthelmintica, 114. 
British Weights and Measures,, 18. 
Bromide of Ammonium, 321. 
Bromide of Lithium, 321. 
Bromide of Potassium, 180, 321. 
Bromine, 320. 
Brominum, 320. 
Buchu, 365. 
Butternut, 214. 

Cadmii Sulphas, 96, 198. 

Caifea, 334. 

CafFea Arabica, 334. 

Caffein, 336. 

Calabar Bean, 328. 

Calamus, 104. 

Calcined Magnesia, 182, 205. 

Calomel, 118, 168, 209, 351. 

Caloric, 72. 

Calumba, 238. 

Calx, 126, 183. 

Calx Chlorinata, 126. 

Camphor, 371. 

Camphora, 371. 

Camphora Officinarum, 371. 

Camphorated Tincture of Opium, 295. 

Canada Thistle, 320. 

Canella, 108. 

Canella Alba, 108. 

Cannabis Indica, 305, 368. 

Cannabis Sativa, 305. 

Cantharides, 70, 356, 368. 

Cantharides with Colodion, 71. 

Cantharis, 70, 356, 368. 

Cantharidin, 70. 

Cantharis Vesicatoria, 70, 356. 

Capsicum, 66, 253. 

Capsicum Anuum, 66. 

Carbolic Acid, 93, 126, 162. 



INDEX. 



381 



Carbo Ligni, 127, 203, 250. 

Carbonate of Ammonium, 255. 

Carbonate of Lithium, 181. 

Carbonate of Magnesium, 182, 206. 

Carbonate of Potassium, 183. 

Carbonate of Sodium, 207. 

Carbon of Wood, 203. 

Cardamom, 108. 

Cardamomum, 108. 

Cardiac Sedatives, 256. 

Cardiac Sedatives, Catalogue of, 257. 

Cardiac Stimulants, 251. 

Cardiac stimulants, Catalogue of, 253. 

Cardiac Tonics, 269. 

Cardiac Tonics, Catalogue of, 269. 

Carageen, 133. 

Carageenin, 133. 

Caryophyllus, 102. 

Caryophyllus Aromaticus, 102. 

Cascarilla, 105. 

Cassia, 217. 

Cassia Acutifolia, 217. 

Cassia Elongata, 217. 

Cassia Alarilandica, 219. 

Casia Obovata, 217. 

Castor, 333. 

Castoreum, 333. 

Castor Fiber, 333. 

Castor Oil, 214. 

Catalytics, 163. 

Catalytics, Catalogue of, 166. 

Catechu, 83. 

Cathartics, 200. 

Cat-heretics, 85. 

Catheretics, Catalogue of, 86. 

Caustic Potassa, 121. 

Caustic Potash, 121. 

Cauterium Actuale, 122. 

Cayenne Pepper, 66, 253. 

Centaurea, 319. 

Centaurea Benedicta, 319. 

Cephaelis Ipecacuanha, 190. 

Cerasus Serotina, 272. 

Cerate of Cantharides, 70. 

Cerates, 35. 

Ceratum Cantharidis, 70. 

Cerebral Sedatives, 307. 

Cerebral Stimulants, 287. 

Cerebral Stimulants, Catalogue of, 289. 

Cerebral Tonics, 314. 

Cerebral Tonics, Catalogue of, 315. 

Cerii Oxalas, 334. 

Cerium, 334. 

Cetraria, 133. 

Cetraria Islandica, 133. 

Chalk, 183. 

Chamomile, 158. 

Charcoal, 127, 203, 250. 



Charta Epispastica, 71. 

Charta Sinapis, 65. 

Chemical Equivalents, 22. 

Chemical Nomenclature, 23. 

Chemical Process, 46. 

Chenopodium, 113. 

Chenopodium Anthelminticum, 113. 

Chimaphila, 179. 

Chimaphila umbellata, 179. 

China Tree, 113. 

Chinese Rhubarb, 211. 

Chloral, 67, 310. 

Chloral Hydrate, 310. 

Chloride of Ammonium, 177. 

Chloride of Iron, 78, 127, 161. 

Chloride of Lime, 126. 

Chloride of Sodium, 127. 

Chloride of Zinc, 78, 94, 127. 

Chlorinated Lime, 126. 

Chlorine, 126. 

Chlorine Water, 127. 

Chlorodyne, 297. 

Chloroform, 67, 177, 296, 309. 

Chloroformum, 177, 296, 309. 

Cholagogue Cathartic, 222. 

Chondrus, 133. 

Chondrus Crispus, 133. 

Chromic Acid, 123. 

Cibus, 148, 233. 

Cimicifuga, 345. 

Cimicifuga Racemosa, 345. 

Cinchona, 339. 

Cinchona Calisaya, 339. 

Cinchonia, 339. 

Cinchonioe Sulphas, 342. 

Cinnamomum, 99. 

Cinnamomum Aromaticum, 99. 

Cinnamomum Zeylanicum, 99. 

Cinnamon, 99. 

Citrate of Caffein, 336. 

Citrate of Iron, 152. 

Citrate of Lithium, 182. 

Citrullus Colocynthis, 225. 

Citrus Aurantium, 107. 

Classification of Remedies, 55. 

Classfication, Table of, 61. 

Climate, 49. 

Cloves, 102. 

Coal-Tar, 93. 

Cocculus Palmatus, 238. 

Cod-Fish, 153. 

Cod-Liver Oil, 153. 

Coffee, 334. 

Cohosh, 346. 

Cold, 265. 

Cold Infusions, 158. 

Collinsonia, 283. 

Collinsonia Canadensis, 283, 






INDEX. 



limn cum Cantharide. 71. 
OoUutories, 4<>. 

Colly ria. 41. 
Collyrium. 

Colocynthiu. 22 
Colocynt! .> _ 
Colambin, 2 - 

Colurabo. 2 B. 

Comfry. 136, 140. 

Common Flax. 131. 

Common Mum;i 

Common Poppy. \ 

Common Salt. 127 

Compound Infusion of Flax-See 

Compound Tincture of Gentian, 243. 

Condiments, 106. 

Conia, 326. 

Conium, 326. 

Conium Maculatum, 326. 

Contusion. 25. 

Convaluh. - 

Convolvulus Scammonium. 223. 

Copaiba, 278 M 

Copaiba Multijuga, 273, ■: 

Copaiva. 278. 358. 

Copper, 318. 

Coptis. 244. 

Coptis Trifolia. 244. 

Coriander. 

Coriandrum, 108. 

Coriandrum Sativum, 108. 

Cornine. 343. 

Cornus, 343. 

Cornus Florida. 343. 

Corrosive Chloride of Mercury, US. 

Corrosive Sublimate, 118, 169. 

Cotton plant, 374. 

Counter Irritation, 63, 68. 

Cranesbill. 79. 

Cream of Tartar, 360. 

Creasote, 125, 163. 

Creasotum. 125. 

Croton Eluteria, 105. 

Croton Oil. 74. 227. 

Croton Tiglium. 74, 227. 

Crystalization. 28. 

Cueurbita Pepo, 114. 

Cucurbitula, 143. 

Culver" s Root, 229. 

Cupping. 2'.'4. 

Cupping Glass. 143. 264. 

Cupri Sulphas. 95. 197. 318. 

Cuprum, 318. 

Cuprum Ammoniatum, 318. 

Cyanide of Potassium, 274, 314. 



imonium, 302. 

Decani 

Decimal Weights and Measures, 19. 
Decoction-. 

Decoction of Azedarach, 113. 
ion of Bla 

Decoction of Cetrnii. L34. 

Decoction of Chondrus. 1 

Decoction of Cinchona. 

Decoction of Cotton Root. 

Decoction of Geranium, 

Decoction of Krameri . 

Decoction of Logwood, B4. 

Decoction of Peruvian Bark, 339, 

Decoction of Pipsissewa, 1 ~ 

Decoction of Pomegranate Root, 114. 

Decoction of Rhatany. 83. 

Decoction of Rubus. 82. 

Decoction of Sabbatia, 245. 

Decoction of Seneca. 2 

Decoction of Stillingia, 174. 

Decoction of Thistle, _ 

Decoction of White Oak, 80. 

Decoction of UV« Crsi, 364. 

Decoctum Senegie. 2 H L'. 

Decoctum Uva Ursi, 304. 

Demulcents, 129. 

Demulcents. Catalogue of, 130. 

Denarcotized Laudanum. L 

Denarcotized Opium. 2 

Deodorized Tincture of Opium, 2 

Depletio, 259. 

Depletion, 68. 

Despumation. 27. 

Dewberry Root, 

Diet, 12. 

Digestion. 2 

Digestive Tonics. 229. 

Digitalis, 270. 363. 

Digitalis. Purpurea, 270, 363. 

Diluents. 157. 

Diluted Alcohol. 2 

Diluted Hydrocyanic Acid, 273, 313. 

Dimorphous Crystals. 28. 

Direct Therapeutic Results, 47. 

Displacement. 32. 

Distillation. 28 

Distilled Water. 2 

Divisions. 2 

Dogwood, 343. 

Dorema Ammoniacum, 2 C 4. 

Dose for Children, 55. 

Dracontium. 286. 

Drastics. 201. 219. 

Drastics. Catalogue of, 220. 

Drinks, 13. 



INDEX. 



383 



Drugs, 7. 

Dry Cupping, 146. 

Dry Potassa, 121. 

Effects of Medicine, 43. 

Efferfescing Draught, 268. 

Effluvia, 10. 
Elaterium, 226. 

Elective Action through Chemical Pro- 
cess, 147. 

Elective Action through Vital Process, 
185. 

Elective Remedies, 46, 147. 

Electricity, 324. 

Electrolysis, 325. 

Electro-Magnetism, 325. 

Elementary Bodies, Properties of, 21. 

Elettaria Cardamomum. 108. 

Elixir of Vitriol, 247, 352. 

Elutriation, 26. 

Emesis, 185. 

Emetics, 185. 

Emetin, 190. 

Emolients, 138. 

Emolients, Catalogue of 139. 

Endermic, 38. 

Enteric Excitants or Cathartics, 200. 

Enteric Excitants, Objects of, 201. 

Epidermic, 38. 

Epsom Salt, 216. 

Ergot, 372. 

Ergota, 372. 

Errhines, 40. 

Escharocics and Catalogue of, 121. 

Essence of Cinnamon, 100. 

Essence of Meat, 149. 

Essence of Peppermint, 104. 

Essential Oils, 67. 

Ether, 67, 305, 309. 

Eucalyptus, 282, 

Eucalyptus Globulus, 282. 

Eugenia Pimenta, 106. 

European Rhubarb, 211. 

Evaporation, 27. 

Excito-Motor Sedatives, 326. 

Excito-Motor Sedatives, Catalogue of 
326. 

Excito-Motor Stimulants, 322. 

Excito-Motor Stimulants, Catalogue of 
322 

Exercise, 11, 203, 232. 

Expression, 26. 

Extract of Belladonna, 304. 

Extract of Butternut. 214. 

Extract of Conium, 327. 

Extract of Digitalis, 271 . 

Extract of Hyoscyamus, 302. 

Extract of Indian Hemp, 306, 369. 



Extract of Jalap, 221. 
Extract of Logwood, 84. 
Extract of Nux Vomica, 323. 
Extract of Peruvian Bark, 341. 
Extract of Rhatany, 83. 
Extract of Seneka, 282. 
Extract of Strammonium, 303. 
Extract of Taraxacum, 354. 
Extractum Belladonna?, 304. 
Extractum Buchu Fluidum, 365. 
Extractum Cannabis, 306, 369. 
Extractum Cimicifuga Fluidum, 346. 
Extractum Conii, 327. 
Extractum Filicis Liquidum, 120. 
Extractum Gossypii Badicis Fluidum, 

375. 
Extractum Hyoscyami, 302. 
Extractum Jalapse, 221. 
Extractum Juglandis, 214. 
Extractum Bhei Fluidum, 212. 
Extractum Senegse, 282. 
Extractum Sennas Fluidum, 218. 
Extractum Spigelige Fluidum, 112. 
Extractum Stramonii, 303. 
Extractum Taraxaci, 354. 
Extractum Uvae Ursi Fluidum, 365. 
Extractum Zingiberis Fluidum, 102. 
Extractum Veratri Viridis Fluidum, 

259. • 

False Manna, 205. 

Fat Manna, 205. 

Fear, 5. 

Fennel, 106. 

Ferri Chloridum, 161. 

Ferri Citras, 152, 

Ferri Iodidum, 172. 

Ferri Persulphas, 163. 

Ferri Sulphas, 152. 

Ferrum, 150. 

Ferrum Redactum, 151. 

Filix Mas, 119. 

Filters, 26. 

Filtration, 26. 

Fit Weed, 320. 

Flake Manna, 205. 

Flax, 131. 

Flaxseed, 131. 

Flaxseed Meal, 140. 

Flour of Meat, 149, 234. 

Flowers, 15. 

Fluid Extract of Black Haw, 376. 

Fluid Extract of Buchu, 365. 

Fluid Extract of Cimicifuga, 346. 

Fluid Extract of Cotton Root, 375. 

Fluid Extract of Ginger, 102. 

Fluid Extract of Rhubarb, 212. 

Fluid Extract of Sarsaparilla, 173, 



38 1 



INDEX. 



Fluid Extract of Senna, 218. 

Fluid Extracl of Spigelia, 112. 

Fluid Extraotof Uva Ursi, 866. 

Fluid Extract of Veratrum Viride, 259. 

Fontioulus, L46. 

Food, 148, 283. 

Forms of Preparation, 29. 

Fowler' s Solution, 170. 

Foxglove, 270. 

Frasera, 240. 

Frasera Walteri, 240. 

Fraxinus, 205. 

Fraxiuus Ornus, 205. 

French and United States Weights, 

Relative Value of. 19. 
Friction, 140. 
Frigidus, 265. 
Fumes, 40. 
Fused Nitrate of Silver, 90. 

Gadus Morrhua, 153. 

Galium Aparine, 180. 

Galla, 80. 

Gallic Acid, 81. 

Galls, 80. 

Galvanism, 324. 

Galvano-Magnetism, 325. 

Gamboge, 224. 

Gambogia, 224. 

Garcinia Gambogia, 224. 

Gastric Juice, 236. 

Gastric or Digestive Tonics, 229. 

Gastric Tonics, Catalogue of, 238. 

Gelsemium, 337, 369. 

Gelsemium Sempervirens, 337. 

General Blood-Letting, 200. 

Genital Sedatives, 309. 

Genital Sedatives, Catalogue of, 309. 

Genital Stimulants, 307. 

Genital Stimulants, Catalogue of, 308. 

Gentian, 242. 

Gentiana, 242. 

Gentiana, Catesbtei, 243. 

Gentiana Lutea, 242. 

Geranium, 79. 

Geranium Maculatum, 79. 

Gillenia, 192. 

Gillenia Trifoliata, 192. 

Ginger, 100. 

Glauber's Salt, 217. 

Glycerina, 135. 

Glycerin, 135. 

Glycerite, 135. 

Glycerole, 135. 

Gold-Thread, 244. 

Gossypii Radicis Cortex, 374. 

Gossypium Herbaceum, 374. 

Graham Bread, 250. 



Granati Radicis Cortex, 11.°.. 
Green Iodide of Mercury, 171. 
Green Vitriol, 152. 
Gum Arabic, 180. 
Gum Water, 181, 
Gutta Percha, 138. 

Habit, 63. 

Hsematinics and Catalogue of, 148. 

Basmatcxylon, 84. 

Ila'inatoxylon Campeachianum, 84. 

Hsesmostasia, 169. 

1 hemostatics, 158. 

Hemostatics, Catalogue of, 100. 

Hatred, 4. 

Heal-All, 283. 

Hemlock, 320. 

Henbane, 301. 

Hepatico-Salivary Stimulants, 347. 

Hepatico-Salivary Stimulants, Cata- 
logue of, 349. 

Hepatic Tonics, 351. 

Hepatic Tonics, Catalogue of, 351. 

Hirudo, 142, 204. 

Hirudo Decora, 142. 

Hirudo Medicinalis, 142. 

Honduras Sars aparilla, 173. 

Hope, 4. 

Hops, 370. 

Humulus Lupulus, 370. 

Hydracids, 24. 

Hydragogues, 201. 

Hydrargyri Chloridum Corrosivum, 
118, 109. 

Hydrargyri Chloridum Mite, 118, 108, 
209. 

Hydrargyri Iodidum Rubrum, 171. 

Hydrargyri Iodidum Viride, 171. 

Hydrargyri Sulphas Flava, 199. 

Hydrargyrum, 117, 100, 208, 349. 

Hydrate of Calcium, 183. 

Hydrate of Chloral, 310. 

Hydrate of Potassium, 121. 

Hydrate of the Protoxide of Potas- 
sium, 121. 

Hygiene, 8. 

Hyoscyamus, 301. 

Hyoscyamus Niger, 301. 

Hypodermic, 39. 

Hypophosphite of Calcium, 317. 

Hypophosphites, 316. 

Ice, 266. 

Iceland Moss, 133. 

Idiosyncrasy, 53. 

Immediate effects of Emetics, 187. 

Impalpable Powder, 41. 

Impluvium, 344. 



INDEX. 



385 



Imponderable Substances, 2. 

Indian Hemp, 305, 368. 

Indian Physic, 192. 

Indian Tobacco, 194. 

Indirect Therapeutic Results, 48. 

Infusions, 33, 158. 

Infusion of Bloodroot, 193. 

Infusion of Calamus, 105. 

Infusion of Capsicum, 253. 

Infusion of Cascarilla, 105. 

Infusion of Chamomile, 158. 

Infusion of Cinchona, 339. 

Infusion of Collinsonia, 283. 

Infusion of Columbo, 240. 

Infusion of Coptis, 244. 

Infusion of Digitalis, 271. 

Infusion of Flaxseed, 132, 158. 

Infusion of Gentian, 242. 

Infusion of Gillenia, 192. 

Infusion of Ginger, 102. 

Infusion of Heal- All, 283. 

Infusion of Kino, 83. 

Infusion of Lobelia, 196. 

Infusion of Logwood, 84. 

Infusion of Nutgalls, 80. 

Infusion of Oak Barks, 80. 

Infusion of Peppermint, 103. 

Infwsion of Peruvian Bark, 339. 

Infusion of Quassia, 244. 

Infusion of Rhatany, 83. 

Infusion of Sabbatia, 245. 

Infusion of Sassafras Pith, 135. 

Infusion of Senna, 218. 

Infusion of Slippery Elm, 133. 

Infusion of Spigelia, 112. 

Infusion of Taraxacum, 353. 

Infusion of Tobacco, 193, 313. 

Infusion of Vanilla, 108. 

Infusion of Wild Cherry, 272. 

Infusum Cascarillge, 105. 

Infusum Calumbse, 240. 

Infusum Gentianae, 242. 

Infusum Lini Compositum, 132. 

Infusum Pruni Virginianae, 272. 

Infusum Quassias, 244. 

Infusum Sennae, 218. 

Infusum Spigeliae, 112. 

Infusum Tabacum, 313. 

Infusum Taraxaci, 353. 

Infusum Zingiberis, 102. 

Inhalation, 40. 

Inspissation, 27. 

Insufflation, 40. 

Introduction, 1. 

Inverse Gastric Excitants or Emetics, 

185. 
Inverse Gastric Excitants, Catalogue 

of, a89. 

25 



Iodide of Iron, 172. 
Iodide of Potassium, 170. 
Iodine, 86, 169. 
Iodine, Fumes of, 87. 
Iodine Ointment, 170. 
Iodinum, 86, 169. 
Iodoform, 96. 
Iodoformum, 96. 
Ipecac, 190. 
Ipecacuanha, 190. 
Ipomaea Jalapa, 220. 
Irish Moss, 133. 
Iron, 150. 
Iron, hot, 122, 163. 
Isomorphous Crystals, 28. 
Issue Pea, 146. 

Jalapa, 220. 
Jalap, 220. 
Jamaica Ginger, 100. 
Jamestown Weed, 302. 
Jerusalem Oak, 113. 
Joy, 4. 

Juglans, 214. 
Juglans Cinerea, 214. 
Juniper, 357. 
Juniperus, 357. 
Juniperus Communis, 357. 
Juniperus Sabina, 357. 

Kameela, 116. 
Kino, 82. 
Koosso, 114. 
Krameria, 83. 
Krameria Triandria, 83. 

Laughing Gas, 310. 
Lavender, 106. 
Lavendula, 106. 
Lavendula Vera, 106. 
Laxatives, 201. 
Laxatives, Catalogue of, 204. 
Leaves, 15. 
Lebens Wecker, 75. 
Leeches, 264. 
Lemonade, 268. 
Leopard's Bane, 323. 
Leptandra, 229. 
Leptandra Virginica, 229. 
Leptandrin, 229. 
Levant Wormseed, 120. 
Licheriin, 133. 
Light, 9. 
Lime, 126, 183. 
Lime Water, 183. 
Lini Farina, 140. 
Liniments, 36. 
Linseed Oil, 138. 



386 



tm>i:x. 



Linam, 181. 

Linum (Jsitatissinuun, 181, 1 li>. 

Liquidambar Orientale, 284. 

Liquid Extraot of Fern, 120. 

Liquid Preparations, 81. 

Liquid Storax, '284. 

Liquor Calcia, 188. 

Liquor Magnesii Citratis, 200. 

Liquor Potassii Arsenitis, 1 7 ' > . 

Liquor Sodas Ghlorinatae, 127. 

Lithia, 181. 

Lithii Bromidum, 821. 

Lithii Carbonas, 181. 

Lithii Citras, 182. 

Lixiviation, 27. 

Lobelia, 194. 

Lobelia Inflata, 194. 

Local Action through Chemical Pro- 
cess, 109. 

Local Action through Mechanical Pro- 
cess, 129. 

Local Action through Vital Process, 
63. 

Local Alteratives, 85. 

Local Blood-letting, 264. 

Local Depletives, 141. 

Local Depletives, Catalogue of, 142. 

Local Remedies, 46, 63. 

Logwood, 84. 

Lotions, 36. 

Love, 3. 

Low Diet, 157. 

Lozenges, 30. 

Lugol's Solution of Iodine, 88, 171. 

Lumbricoides, 110. 

Lunar Caustic, 90. 

Lungs, 40. 

Lupulin, 370. 

Lupulina, 370. 

Mace, 107. 

Maceration, 26. 

Magnesia, 182, 205. 

Magnesii Carbonas, 182, 206. 

Magnesii Sulphas, 216. 

Male Fern, 119. 

Malt Liquors, 300. 

Manganese, 180. 

Manna, 205. 

Mannite, 205. 

Marshmallow, 136. 

Materia Medica, 1. 

Material Agents, 2, 21. 

Matter, 22. 

May Apple, 222. 

McMunn's Elixir of Opium, 295. 

Mecca Senna, 217. 

Mechanical Counter-irritants, 141. 



Mechanical Counter-irritants, Cata- 
logue of, I 12. 

Mechanical Process, •}•'». 

Mechanical Operations of Pharmacy, 
26. 

Medioines, 7. 

Melia Azedaraoh, 113. 

Mentha Piperita, 103. 

Mentha Viridis, 104. 

Mercurial Ointment, 118. 

Mercury, 117, 166, 208, 349. 

Mesmerism, 6. 

Mezereon, 180. 

Mild Chloride of Mercury, 118, 168, 
209. 

Mild Enteric Excitants, 201. 

Mild Enteric Excitants, Catalogue of, 
204. 

Mineral Acids, 122, 245, 351. 

Modus Operandi of Remedies, 43. 

Molasses. 204. 

Momordica Elaterium, 226. 

Morphia, 293. 

Morphise Acetas, 293. 

Morphias Murias, 294. 

Morphias Sulphas, 294. 

Morphine, 293. 

Moschus, 333. 

Moschus Moschiferus, 333. 

Moxa, 146. 

Moxiburium, 146. 

Mucilage of Gum Arabic, 131. 

Mucilago Acacias, 131. 

Muriate of Ammonia, 177. 

Muriate of Morphia, 294. 

Muriated Tincture of Iron, 249, 365. 

Muriatic Acid, 127, 248, 352. 

Musk, 333. 

Musk Deer, 333. 

Mustard, 64, 105. 

Mustard Paper, 65. 

Myristica, 107. 

Myristica Fragrans, 107. 

Myrospermum Peruiferum, 280. 

Myrospermum Toluiferum, 279. 

Naptha, 285. 

Narthex Assafcetida, 330. 

Nicotiana Tabacum, 193, 312. 

Nitrate of Potassium, 267, 359. 

Nitrate of Silver, 90, 163, 318. 

Nitre, 267. 

Nitric Acid, 122, 247, 352. 

Nitromuriatic Acid, 249, 352. 

Nitrous Oxide, 310. 

Nomenclature, 23. 

Nose, 39. 

Noxious Effluvia, 10. 



INDEX. 



387 



Nutmeg, 107. 
Nux Vomica, 822. 

Oil of Amber, 332. 

Oil of Chenopodium, 113. 

Oil of Cinnamon, 67, 100. 

Oil of Cloves, 67, 103. 

Oil of Copaiva, 279. 

Oil of Eucalyptus, 283. 

Oil of Peppermint, 67, 104. 

Oil of Pumpkinseed, 114. 

Oil of Savin, 358. 

Oil of Turpentine, 65, 254, 277, 355. 

Ointments, 35. 

Ointment of Iodine, 170. 

Olea Europcea, 136, 204. 

Oleoresin of Eern, 120. 

Oleoresin of Ginger, 102. 

Oleoresina Zingiberis, 102. 

Oleum Caryophilli, 103. 

Oleum Chenopodii, 113. 

Oleum Cinnamomi, 100. 

Oleum Copaibas, 279. 

Oleum Eucalypti, 283. 

Oleum Juniperi, 357. 

Oleum Lini, 138. 

Oleum Menthae Piperitse. 104. 

Oleum Morrhuse, 153. 

Oleum Myristicse, 107. 

Oleum Olivse, 136, 204. 

Oleum Peponis, 114. 

Oleum Ricini, 214. 

Oleum Sabinse, 358. 

Oleum Succini, 332. 

Oleum Terebinthinse, 65, 254, 277, 355. 

Oleum Tiglii, 74, 227. 

Olive Oil, 136, 204. 

Opium, 289, 376. 

Orange Peel, 107. 

Orders, 62. 

Ornus, 205. 

Ornus Europaea, 205. 

Oxacids, 23. 

Oxalate of Cerium, 334. 

Oxide of Calcium, 183. 

Oxide of Magnesium, 182. 

Packing Drugs, 16. 

Palma Christi, 214. 

Papaver Somniferum, 289. 

Paregoric, 295. 

Parts of Body for Application, 36. 

Pearl Ash, 183. 

Pediluvium, 67. 

Pepo, 114. 

Pepper, 107. 

Peppermint, 103. 

Pepsin, 236, 237. 



Perchloride of Iron, 96, 161. 

Percolation, 27, 32. 

Perennials, 14. 

Peristaltic Action, 185. 

Permanganate of Potassium, 180. 

Persulphate of Iron, 96, 163. 

Peruvian Bark, 339. 

Petroleum, 93. 

Pharmaceutic Chemistry. 21. 

Pharmacological Substances, 7. 

Pharmacology, 1. 

Pharmacy, 13. 

Phellandrium Aquaticum, 284. 

Phlebotomy, 260. 

Phosphorus, 315. 

Phosphorous Acid, 316. 

Physical Remedies, 7. 

Physiological Action, 43. 

Physiological Classification, 61. 

Physostigma, 328. 

Physostigma Venenosum, 328. 

Pill of Mercury, 168, 209, 350. 

Pills, 29. 

Pilula Hydrargyri, 168, 209, 350. 

Pimenta, 106. 

Pimento, 106. 

Pinkroot, 111. 

Pinus Abie-, 65. 

Pinus Palustris, 65, 277. 

Piper, 107. 

Piperine, 107. 

Piper Nigrum, 107. 

Pipsissewa, 179. 

Plasters, 31. 

Plumbi Acetas, 77, 160. 

Podophyllum, 222. 

Podophyllum Peltatum, 222. 

Polygala Senega, 280. 

Ponderable Substances, 2. 

Poppy, 289. 

Potash, 183. 

Potassa, 121. 

Potassii Bicarbonas, 184. 

Potassii Bitartras, 360. 

Potassii Bromidum, 321. 

Potassii Carbonas, 183. 

Potassii Carbonas Pura, 184. 

Potassii Cyanidum, 274, 314. 

Potassii Iodidum, 170. 

Potassii Nitras, 267, 359. 

Poultice, 138. 

Powders, 30. 

Powder of Bloodroot, 193. 

Preparations, 29. 

Primary Action, 47. 

Properties of Bodies, 21. 

Probe, Uterine, 41. 

Proof Spirit, 299. 



388 



INDEX. 



Prostrating Cerebral Sedatives, 812. 
Prostrating Cerebral Sedatives, Cata- 
logue of, 812. 
Protoohloride of .Mercury, 861. 

Protoxide of Lithium, 181. 
Protoxide of Nitrogen, 810. 
Protoxide of Potassium, 121. 
Prunus Virginiana, '2~2. 

I'ru^sic Acid, -.'513. 

Psychical Influences, 2. 

Pterocarpus Marsupium, 82. 

Pulveres Efl'ervescentes Aperientes, 207 

Pulverization, 25. 

Pulverized Columbo, 240. 

Pulverized Digitalis, 271. 

Pulverized Elm Bark, 139. 

Pulverized Flaxseed, 140. 

Pulverized Ipecac, 190. 

Pulverized Jalap, 221. 

Pulvis Ulmi, 139. 

Pumpkinseed, 114. 

Pump, Stomach, 42. 

Punica Granatum, 113. 

Pure Carbonate of Potassium, 184. 

Purgatives, 201,207. 

Purgatives, Catalogue of, 208. 

Pustulants, 73. 

Pustulants, Catalogue of, 73. 

Quassia, 243. 
Quassia Amara, 243. 
Quassia Excelsa, 243. 
Queen's Delight, 173. 
Quercus Alba, 80. 
Quercus lnfectoria, 80. 
Quercus Tinctoria, 80. 
Quick Lime, 183. 
Quinia, 339. 
Quinise Sulphas, 341. 
Quinine, 341. 

Raspberry Root, 82. 

Rectified Spirit, 299. 

Rectum, 37. 

Red Iodide of Mercury, 171. 

Red Pepper, 66. 

Reduced Iron, 151. 

Reflex Nervous Stimulants, 329. 

Reflex Nervous Stimulants, Catalogue 
of, 330. 

Remedies, 2. 

Remedies that Affect Adventitious Sub- 
stances and Structures, 109. 

Remedies that Affect the Alimentary 
Canal, 185. 

Remedies that Affect the Blood, 147. 

Remedies that Affect the Heart, 251. 



Remedies thai A.flPeoi the Internal and 
Externa] Surfaces, L29. 

Remedies thai Effect the .Mucous Mem- 
branes, 27!. 

Remedies that Affect the Nervous Sys- 
tem, 286. 

Remedies that Affect the Procreative 
I Organs. ; !*i'i. 

Remedies that Affect the Secernent 
System, 846. 

Remedies that Affect the Skin, 68. 

Remedies that Affect all Soft Tissues, 
75. 

Renal Sedatives, 358. 

Renal Sedatives, Catalogue of, 359. 

Renal Stimulants, 354. 

Renal Stimulants, Catalogue of, 355. 

Renal Tonics, 361. 

Renal Tonics, Catalogue of, 362. 

Rennet, 237. 

Resina Jalapae, 221. 

Resina Podophylli, 222. 

Resin of Jalap, 221. 

Resin of Podophyllum, 222. 

Revulsion, 63, 68. 

Rhatany, 83. 

Rheum, 210. 

Rheum Compactum, 210. 

Rheum Palmatum, 210. 

Rheum Undulatum, 210. 

Rhubarb, 210. 

Ricinus Communis, 214. 

Rigoline, 266. 

Roots, 14. 

Rottlera, 116. 

Rottlera Tinctoria, 116. 

Rubefacients, 63. 

Rubefacients, Catalogue of, 64. 

Rubus, 81. 

Rubus Canadensis, 81. 

Rubus Trivialis, 81. 

Rubus Villosus, 81. 

Sabbatia, 245. 

Sabbatia Angularis, 245. 

Sabina, 357. 

Salicin, 343. 

Salix, 343. 

Salix Alba, 343. 

Salt, 127. 

Saltpetre, 267. 

Sanguinaria, 193. 

Sanguinaria Canadensis, 193, 

Santonica, 120. 

Santonin, 120. 

Santoninum, 120. 

Sarcoptis Hominis, 117. 



INDEX. 



389 



Sarsaparilla, 172. 

Sassafras Medulla, 134. 

Sassafras Officinale, 134. 

Sassafras Pith, 134. 

Savin, 357. 

Scammonium, 223. 

Scammony, 223. 

Scarification, 144, 265. 

Scilla, 362. 

Scilla Maritima, 362. 

Seaton, 145. 

Secale Sereale, 372. 

Secondary Action, 47. 

Seeds, 15. 

Seidlitz Powders, 207. 

Semifluids, 34. 

Senaga, 280. 

Seneka, 280. 

Senna, 217. 

Sesamum, 134. 

Sesamum Indicum, 134. 

Setaceum, 145. 

Sex, 52. 

Shellac, 138. 

Shower-bath, 344. 

Simple Bodies, 21. 

Simple Syrup, 35. 

Sinapis, 64, 105. 

Sinapis Alba, 64. 

Sinapism, 65. 

Sinapis Niger, 64. 

Skin, Application to, 38. 

Skin, Remedies for, 63. 

Slaked Lime, 183. 

Sleep, 12. 

Slippery Elm, 132, 139. 

Slippery Elm Bark, 132. 

Smilax Officinalis, 172. 

Smilax Sarsaparilla, 172. 

Soda, 184. 

Sodii Chloridum, 127. 

Sodii Sulphas, 217. 

Solid Extracts, 31. 

Solid Extract of Logwood, 84. 

Solid Extract of Rhatany, 83. 

Solid Preparations, 29. 

Solutions, 26, 34. 

Solution of Arsenite of Potassium, 176. 

Solution of Chlorinated Soda, 127. 

Solution of Citrate of Magnesium, 206. 

Solution of Lime, 183. 

Solvent of Food, 236. 

Somatical Remedies, 7. 

Sorrow, 5. 

Spansemics, 156. 

Spanish Flies, 70, 356. 

Spasmodics, and Catalogue of, 322. 

Spear Mint, 104. 



Spigelia, 111. 

Spigelia Marilandica, 111. 

Spinal Sedatives, 336. 

Spinal Sedatives, Catalogue of, 337. 

Spinal or Reflex Nervous Stimulants, 

329. 
Spinal Stimulants, Catalogue of, 330. 
Spinal Tonics, 338. 
Spinal Tonics, Catalogue of, 339. 
Spirit of Lavender, 106. 
Spirit of Nitrous Ether, 360. 
Spirit of Turpentine, 66, 277, 355. 
Spiritus iEtheris Nitrosi, 360. 
Spiritus Lavendulse, 106. 
Spiritus Rectificatus, 299. 
Spotted Cranesbill, 79. 
Spray of Iodine, 88. 
Spritze, 41. 
Squill, 362. 

Squirting Cucumber, 226. 
Starch, 135. 
Stillingia, 173. 
Stillingia Sylvatica, 173. 
Stomach, 36. 
Stomach Pump, 42. 
Storax, 284. 
Stramonium, 302. 
Strychnia, 322. 
Strychnos Nux Vomica, 322. 
Styptic Colloid, 163. 
Styptics, 158. 
Styrax, 284. 
Styrax Officinale, 284. 
Subcarbonate of Bismuth, 250. 
Subcarbonate of Iron, 151. 
Sublimation, 28. 

Subnitrate of Bismuth, 137, 250. 
Sub-Order, 62. 
Subsulphate of Iron, 163. 
Succinum, 332. 
Sugar of Lead, 77, 160. 
Sulphate Aluminum and Ammonium, 

78. 
Sulphate of Cadmium, 78, 96, 198. 
Sulphate of Cinchonia, 342. 
Sulphate of Copper, 78, 95, 197, 318. 
Sulphate of Iron, 152. 
Sulphate of Magnesium, 216. 
Sulphate of Morphia, 294. 
Sulphate of Quinia, 341. 
Sulphate of Sodium, 217. 
Sulphate of Zinc, 78, 95, 197, 317. 
Sulphur, 180. 
Sulphuric Acid, 247, 352. 
Sulphurous Acid, 176. 
Suppositories, 30. 
Svapnia, 293. 
Sweet Flag, 104. 



r>oo 



INDEX. 



Sweet Oil, 204. 

Sweel Spirit of Nitre, 360. 

Symbols of Weights and Measures, 17. 

Symphytum, 1 86, 1 to. 

Symphytum Officinale, 136, 140. 

Synthesis, 22. 

Syphon. Stomach, I-!. 

Syrup, '204. * 

Syrup of Ginger, 102. 

Syrup of Iodide of Iron, 172. 

Syrup of Ipecacuanha, 191. 

Syrup of Sarsaparilla, 173. 

Syrup of Sarsaparilla and Stillingia, 

17;:. 

Syrup of Seneka, 282. 
Syrup of Senna, 219. 
Syrup of Squill, 362. 
Syrup of Rhubarb, 211. 
Syrup of Wild Cherry, 272. 
Syrups, 35. 

Syrupus Ferri Iodidi, 172. 
Syrupus Ipecacuanhne, 191. 
Syrupus Pruni Virginianas, 272. 
Syrupus Rhei, 211. 
Syrupus Rhei Aromaticus, 212. 
Syrupus Sarsaparilla, 173. 
Syrupus Scillas, 362. 
Syrupus Senegas, 282. 
Syrupus Sennas, 
Syrupus Zingiberis, 102. 

Tabacum, 193, 312. 

Table Tipping, 6. 

Taenia, 110. 

Tasnia Lata, 110. 

Tasnia Solium, 110. 

Tapeworm, 110. 

Tannic Acid, 81. 

Tannin, 81. 

Taraxacum, 353. 

Taraxacum dens-leonis, 353. 

Tartaric Acid, 207. 

Tartarized Antimony, 74. 

Tartrate of Antimony and Potassium, 

196, 266. 
Tartrate of Potassium, 207. 
Tartrate of Sodium, 207. 
Temperament, 54. 
Tents, 41. 

Teroxide of Chromium, 123. 
The Pack, 141. 
Thistle, 319. 
Thornapple, 302. 

Thorough Enteric Excitants, 201, 207. 
Thorough Enteric Excitants, Catalogue 

of, 208. 
Therapeutics, 2. 
Tinctura Assafoetidas, 332. 



Tiiicttira Belladonna. 
Tinctura Cannabis, 807. 
Tinctura Cantharis, 857, ■■ 

Tinctura Capsici, 258. 
Tinctura Castorei, 38 1. 
Tinctura Cimicifugffi, 36 1. 

Tinctura Cinnamomi, loo. 
Tinctura Conii, 327. 
Tinctura Digitalis, 271, 364. 
Tinctura Ergotffi, '■'>' I. 
Tinctura Ferri Chloridi, 127, 365. 
Tinctura Ferri Muriatis, 249. 
Tinctura Gentians Composita. 243. 
Tinctura Hyoscyanii, 302. 
Tinctura Iodini, 88, 171. 
Tinctura Jalapse, 222. 
Tinctura Kino, 83. 
Tinctura Lobelias, 196. 
Tinctura Lupulinas, 371. 
Tinctura Olei Menthas Piperita?, 104. 
Tinctura Opii, 294. 
Tinctura Opii Acetatis, 295. 
Tinctura Opii Camphorata, 295. 
Tinctura Opii Deodorata, 295. 
Tinctura Quassias, 244. 
Tinctura Sanguinarias, 193. 
Tinctura Sennas, 219. 
Tinctura Stramonii, 303. 
Tinctura Tolutanum, 280. 
Tinctura Veratri Viridis, 259. 
Tinctura Zingiberis, 102. 
Tinctures, 32. 

Tincture of Assafcetida, 332. 
Tincture of Belladonna, 304. 
Tincture of Bloodroot, 193. 
Tincture of Cantharides, 357, 368. 
Tincture of Capsicum, 253. 
Tincture of Castor, 334. 
Tincture of Catechu, 84. 
Tincture of Cimicifuga, 346. 
Tincture of Cinchona, 339. 
Tincture of Cinnamon, 100. 
Tincture of Chloride of Iron, 127. 
Tincture of Conium, 327. 
Tincture of Digitalis, 271, 364. 
Tincture of Ergot, 374 
Tincture of Gelsemium, 387, 370. 
Tincture of Ginger, 102. 
Tincture of Goldthread, 245. 
Tincture of Hemp, 307. 
Tincture of Hyoscyamus, 302. 
Tincture of Iodine, 88, 171. 
Tincture of Jalap, 222. 
Tincture of Kameela, 117. 
Tincture of Kino, 83. 
Tincture of Lobelia, 196. 
Tincture of Lupulin, 371, 
Tincture of Nux Vomica, 323. 



INDEX. 



391 



Tincture of Opium, 294. 

Tincture of Peruvian Bark, 389. 

Tincture of the Oil of Peppermint, 104 

Tincture of Quassia, 244. 

Tincture of Rhatany, 83. 

Tincture of Senna, 219. 

Tincture of Stillingia, 174. 

Tincture of Stramonium, 303. 

Tincture of Tolu, 280. 

Tincture of Veratrum Viride, 259. 

Tincture of Water-Hemlock, 284. 

Tincture of Yellow Jasmine, 338. 

Tobacco, 193, 312. 

Transfusio, 154. 

Transfusion, 154. 

Triticum Vulgare, 135. 

Troches, 30. 

Troy Weight, 17. 

Turpeth Mineral, 199. 

Ulmus, 132. 

Ulmus Fulva, 132. 

Unguentum Hydrargyri, 118. 

Unguentum Iodinii, 170. 

Uterine Sedatives, 375. 

Uterine Sedatives, Catalogue of, 376. 

Uterine Stimulants, 371. 

Uterine Stimulants, Catalogue of, 372. 

Uterine Syringe, 41, 89, 93. 

Uva Ursi, 364. 

Vanilla, 108. 

Vanilla Aromatica, 108. 

Vapor, 41. 

Naporization, 27. 

Venesection, 260. 

Veratrum Viride, 257. 

Veronica, 229. 

Vesicants, 68. 

Vesicants, Catalogue of, 70. 

Vesicle, 68. 

Viburnum, 376. 

Viburnum Prunifolium, 376. 

Vinegar of Cantharides, 72. 



Vinegar of Lobelia, 196. 

Vinegars, 34. 

Violent Enteric Excitants, 201, 219. 

Violent Enteric Excitants, Catalogue 

of, 220. 
Vinum Ergotae, 374. 
Vinum Ipecacuanhae, 191. 
Virgin Oil, 136. 
Vital Process, 47, 63. 

Walnut Leaves, 180. 

Water, 11. 

Water, Cool, 157, 265. 

Water, Distilled, 28. 

Water-Hemlock, 284. 

Water, Hot, 73, 141. 

Water, Warm, 141. 

Weights and Measures, 17, 18, 19, 20. 

Wheat Bran, 204. 

Whisky, 300. 

White Ginger, 100. 

White Oak, 80. 

White Poppy, 289. 

White Walnut, 214. 

White Willow, 343. 

Wild Cherry, 272. 

Willow, 343. 

Wine of Ergot, 374. 

Wine of Ipecac, 191, 

Wines, 33, 300. 

Wood Charcoal, 203. 

Woorari, 327. 

Wormseed, 113. 

Xanthoxylum, 180. 

Yellow Gentian, 242. 
Yellow Jasmine, 331. 
Yellow Sulphate of Mercury, 199. 

Zinci Chloridum, 94, 127. 
Zinci Sulphas, 95, 197, 317. 
Zingiber, 100. 
Zingiber Officinale, 100. 



LIBRARY OF CONGRESS 

■II! 



0002^0^3^0 



